Either transthoracic or transesophageal echocardiography can be used.
Features of an atrial myxoma on ultrasound:
(1) The tumor usually
arises from the atrial septum, but occasionally arises in the atrial appendage.
(2) The tumor may show a short pedicle.
(3) The appearance is heterogeneous, often with small lucencies.
(4) The tumor does not decrease if placed on anticoagulants.
(5) The tumor may grow through the foramen ovale.
Differential diagnosis:
(1) atrial thrombus
(2) valvular vegetation
(3) other cardiac tumor
Features of an atrial thrombus:
(1) The lesion may be homogeneous or may show a central hypoechoic center (associated with liquefactive necrosis).
(2) The lesion usually arises in the atrial appendage.
(3) The lesion will eventually decrease in size if the patient is anticoagulated.
