Left Ventricular Cardiac Hemangioma Presenting With Atypical Chest Pain

A 54-year-old male patient presented with atypical chest pain and exertional dyspnea. The physical examination and chest x-ray were unremarkable; the ECG showed sinus rhythm with left-axis deviation and a pathological Sokolow-Index with concomitant ST-depression in leads I, aVL, and V5–V6. Transthoracic echocardiography revealed the presence of a homogenously echodense, mobile left ventricular mass (dimensions: 15×12 mm) attached to the intraventricular septum (Figure, E). Cardiac magnetic resonance imaging was performed for tissue characterization: On T1-weighted imaging (Figure, A), the mass was isointense compared with the left ventricular myocardium, whereas on T2-weighted imaging (Figure, B), homogeneously bright signal intensity was found. No signs of infiltrative growth were seen. During first-pass infusion of a gadolinium-containing contrast agent, no relevant signal intensity increase could be detected; however, on postcontrast imaging (delayed enhancement technique), some contrast agent uptake was detected. Figure. A, T1-weighted imaging with fast-spin echo and blackblood suppression in 4-chamber view. The tumor has an intermediate signal …