Sandbox: table diagnosis myxoa

The table below summarizes the findings that differentiate Cardiac Myxoma from other conditions that cause Emboli and hemorrhage:

Imaging Technique	Features	Description	Specificity	Limitations
Two- or three-dimensional echocardiography	Echocardiography is usually the initial modality used for identification and evaluation of cardiac myxomas.Moreover, echocardiography can be useful to assess the mobility of the tumor, as it often protrude through valve flaps.	They appear as hyperechogenic lesions with a well-defined stalk.	D	E
MRI	CMR imaging plays a significant role in the evaluation of cardiac masses and is of greatest value when echocardiographic findings are suboptimal or when the lesion has an atypical location or appearance.	Cardiac myxomas appear spherical or ovoid with lobular contours, irregular in shape. T1: tend to be low to intermediate signal, but areas of haemorrhage may be high T2: can be variable due to heterogeneity in tumour componants; e.g calcific components > low signal; myxomatous components > high signal GE (gradient echo): may show blooming of calcific components T1 C+ (Gd): shows enhancement (important discriminator from a thrombus) demonstrates uniform heterogeneous enhancement.	D	E
CT	Intracardiac heterogeneously low attenuating mass. The attenuation is usally lower than that of myocardium, coarse dystrophic calcification is common.	C	D	E
Angiography	Coronary angiography may be performed to detect vascular supply of the tumor by the coronary arteries	The angiographic findings of cardiac myxoma demonstrate feeding vessels, contrast medium poolings, and clusters of tortuous vessels that correspond to tumor vasculature.	D	E
Chest x-ray		Results can be normal. Otherwise, common findings include cardiomegaly, left atrial enlargement, vascular redistribution, prominent pulmonary trunk, and intracardiac tumoral calcification(rare).	D	E