Prior transesophageal echocardiography reported a calcific, semimobile structure extending into the left atrium. Cardiac MRI was done for further evaluation.
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There is a band-like hypointense structure, measuring 16 mm in length, protruding into the left atrial lumen between the left superior pulmonary vein and left atrial appendage. The features of the structure are compatible with a prominent coumadin ridge.
A coumadin ridge is a band-like embryological remnant in the left atrium between the left superior pulmonary vein and the left atrial appendage. The coalition of the left superior pulmonary vein and left atrial appendage results to a fold of lateral left atrial wall which may protrude into the endocardial surface of the left atrium. It can be mistaken as a mass or thrombus on echocardiography.
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