Echocardiographic and radiological evaluation of an unusual aortic root mass in an asymptomatic patient: a case report

Background Incidental echocardiographic findings in the asymptomatic patient can present a diagnostic challenge to the clinician. This case report demonstrates that both natural occurring and iatrogenic causes should be considered in the differential diagnosis of isolated aortic root masses. Case Summary A patient presenting for a routine transthoracic echocardiogram to evaluate worsening breathlessness on exertion is found to have an unexpected aortic root mass. Due to the unusual appearances of the aortic root mass, it is further evaluated with additional imaging modalities, including transoesophageal echocardiogram and computed tomography coronary angiography. The mass is fully characterized following the computed tomography coronary angiography as a right coronary artery stent, from a previous coronary angioplasty, protruding into the lumen of the aortic root. No further investigation or intervention is required. Discussion A wide differential diagnosis of focal aortic root masses is presented. The non-invasive characterization of such masses can present a challenge. This case demonstrates the value of a multimodality imaging approach, including transthoracic, transoesophageal echocardiography, and computed tomography coronary angiography, in the evaluation of such masses.