Chewing Gum Inside the Heart

A 73-year-old woman who had undergone hysterectomy and radiotherapy 17 years previously for uterine leiomyosarcoma presented to the emergency department with new-onset exertional shortness of breath of 4-days duration. On admission, she was dizzy and tachypneic at rest. Chest auscultation revealed an apical diastolic murmur, gallop, and bilateral rales, and bilateral pleural effusion and interstitial edema were noticed in the chest x-ray film. In order to rule out pulmonary embolism, a thoracic angio–computed tomography (CT) scan was performed showing enlarged right paratracheal lymph nodes and a left atrial mass extending to the left ventricle (Figure 1). Transthoracic echocardiography confirmed the presence of a large mass in the left atrium prolapsing across the mitral valve into the left ventricle during early diastole and returning …