#1: What is your differential for this abnormality?
#2: What is the most likely cause of the abnormality?
Explanation: This video loop shows something near the orifice of the left atrial appendage. Our differential was thormbus, artifact, or tumor (myoxoma).
It is very small and the LAA was contracting normally as does the left atrium. Since there was no stasis, and we felt the shadow was real, we felt that the shadow is myxoma.
A thrombus can mimick a myxoma and vice versa.
Hemangiomas have occurred in the left atrial appendage but are usually large. While this mass was small, there was no associated signs of stasis, making thrombus less likely.
Although very rare, LAA myxomas have been reported.
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