Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2015; 3(9): 831-834
Published online Sep 16, 2015. doi: 10.12998/wjcc.v3.i9.831
Coumadin ridge: An incidental finding of a left atrial pseudotumor on transthoracic echocardiography
Aadil Mubeen Lodhi, Tin Nguyen, Christopher Bianco, Assad Movahed
Aadil Mubeen Lodhi, Tin Nguyen, Christopher Bianco, Assad Movahed, Department of Cardiovascular Sciences, East Carolina University, Brody School of Medicine, East Carolina Heart Institute, Greenville, NC 27834, United States
Author contributions: Lodhi AM, Nguyen T, Bianco C and Movahed A contributed to the manuscript writing and revision.
Supported by The “East Carolina Heart Institute”.
Institutional review board statement: This study was case report and so no approval was required from our institution.
Informed consent statement: Consent was obtained from the patient at the time of investigations, but not at the time of writing patient case report.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Assad Movahed, MD, Department of Cardiovascular Sciences, East Carolina University, Brody School of Medicine, East Carolina Heart Institute, 115 Heart Drive, Mail Stop 651, Greenville, NC 27834, United States. movaheda@ecu.edu
Telephone: +1-252-7444400 Fax: +1-252-7447724
Received: January 5, 2015
Peer-review started: January 7, 2015
First decision: March 6, 2015
Revised: March 30, 2015
Accepted: June 15, 2015
Article in press: June 16, 2015
Published online: September 16, 2015
Abstract

Coumadin ridge is a normal anatomic variant that is occasionally found in the left atrium. It can present as a linear or nodular mass which can undulate with cardiac motion and if particularly prominent, can easily be mistaken for a tumor or thrombus. Careful evaluation and consideration of the common variants discussed in this review can help limit misdiagnosis, as well as unnecessary workup and treatment. We present a case of coumadin ridge that was found on a patient using two-dimensional transthoracic echocardiography.

Keywords: Coumadin ridge, Pseudotumor, Warfarin ridge, Left atrial pseudotumor

Core tip: As we improve imaging modalities, normal anatomic variants of the heart are coming to our attention more frequently. Coumadin ridge is an example of such a variant that is occasionally found on various imaging modalities of the heart, including transthoracic echocardiography, transesophageal echocardiography, cardiac magnetic imaging, among others. Coumadin ridge is a term that refers to a part of the left atrium that lies between the left atrial appendage and the left superior pulmonary vein. Since this is a not a common finding, and due to its shape and location, it has the potential of being misdiagnosed as a left atrial myoxma or thrombus.