Pulmonary Vein Stenosis Due to a Compressive Malignant Tumor Detected by Transesophageal Echocardiography

A 72-year-old man presented to the emergency department with a history suggestive of a transient ischemic attack. On physical examination, he had bilateral expiratory rhonchi and no residual neurological deficit. A chest radiograph, obtained on admission, did not reveal any obvious lung mass or nodule. As part of the evaluation protocol, a transesophageal echocardiogram (TEE) was performed to rule out a possible cardioembolic etiology. The TEE showed normal left ventricular systolic function, mildly dilated right ventricle with moderately elevated right ventricular systolic pressure, and a patent foramen ovale with a right-to-left …