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Figure legends
Figure 1(A-C): Transesophageal echocardiography showing mobile mass in the right atrium in the bicaval (A) and short axis (B) views (arrows). Chest CT (C) showing the same mass in the right atrium (arrow). The mass is attached to the septal leaflet of the tricuspid valve. The differential diagnosis was between right sided atrial myxoma and fibroelastoma.
Figure 2: Coronary angiography showing patent left system (left) and right coronary artery (right) with no evidence for atherosclerotic obstructive lesions.
Figure 3: The resected mass from the right atrium. The pathology findings were consistent with fibroelastoma. This is a rare location of fibroelastoma as the most common sites for these tumors are the ventricular side of the aortic valve followed by the atrial side of the mitral valve.
Figure 4(A-B): ECG showing diffuse ST segment changes with minimal ST elevation in the anterior leads (A), finding that has been reported in many patients with TTS. The initial ECG before surgery was completely normal. Apical four chambers view (B) showing prominent apical ballooning typical for takotsubo. Cine echocardiography showed basal hypercontractility with dynamic mitral regurgitation secondary to left ventricular outflow tract obstruction.