Intracardiac Thrombus in the Right Heart: An Atypical Presentation of Behçet's Disease

Abstract

Intracardiac thrombosis is a rare complication of Behçet's disease (BD), which can present as an intracardiac tumor. Its discovery precedes the diagnosis of Behçet's disease in half of the cases. We report the observation of a 64-year-old patient with a history of bipolar aphthosis, admitted to our department for etiological work-up of a prolonged fever disorder. Transthoracic echocardiography revealed a right ventricular mass appended to the tricuspid valve. Cardiac MRI was consistent with thrombus. The case was discussed in a multidisciplinary team including cardiologists, radiologists and internists, and the diagnosis of Behçet's disease with cardiac complications was established. The patient was treated with immunosuppressive therapy, with a favorable clinical and echocardiographic evolution. The discovery of an intracardiac mass should prompt the diagnosis of cardiac thrombus and Behçet's disease, even in the absence of predisposing ethnic or geographical factors.