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The intravenous contrast has been partially obstructed at the level of the SVC insertion into the right atrium. There is thickening of the inter atrial septum extending into the lateral right atrial wall which measure -50 to -70 HU. This is iso-dense to subcutaneous fat and the cardiac fat pad. There is a small central portion of the septum spared by the adipose hypertrophy in the expected location of the fossa ovalis. The presence of adipose thickening of the inter atrial septum with sparing of the fossa ovalis is suggestive of an incidental finding of lipomatous hypertrophy of the inter atrial septum.