What is the important take home message from the case?
The history of atrial fibrillation was not provided at the time the CT was read. So makes the diagnosis even more difficult for a radiologist. May be cardiac MRI would have helped in tissue characterization of the atrial mass better.
Why did the mass enhance?
1. May be real from the thrombus. or 2. Volume averaging as this was not a gated CTA of heart.
There is a left atrial appendage clip in place.
Sternotomy changes and intact sternal suture wires.