Elderly Woman With Atrial Fibrillation

A 78-year-old woman with rheumatic heart disease and severe mitral stenosis presented to the emergency department with chest tightness. She was in atrial fibrillation, at 100 beats/min. Two-dimensional transthoracic echocardiography (Figure and Video E1, available online at http://ift.tt/P50aok) showed a circular mass 3.6 cm in diameter in the left atrium. This was unattached and could not cross the mitral valve.

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