On right parasternal long axis view, optimized for left and right atrium, the presence of a heterogeneous mass adjacent to the right atrium is evidenced. Other findings:

• small right atrium
• thicker mitral valve leaflets
• mild mitral valve regurgitation on color flow
• mild diffuse hypertrophy from the left ventricle

On right parasternal short axis view, at the level of aorta and left atrium, the mass is afecting right atrium free wall and pressing on the cavity.

On left apical views, optimized for right heart, the mass is clearly located on the right atrium.

With the thoracic ultrasound the right atrial mass is showing mixed echogenicity with cavitary component.

It is possible to appreciate a thicker pleural line, presence of multiple anechoic nodules and B-lines on the pulmonary parenchyma.

Liver is enlarged, with rounded lobe margins, and multiple heterogeneous nodules are afecting the hepatic parenchyma.

Some pulmonary B-lines are visible across the diaphragm.

Angeles Carrión DVM, Accre. AVEPA in Cardiology. Vetocardia, cardiología y ecografía veterinaria, Murcia, Spain.

Based on localization and appearance of the cardiac mass, findings are compatible with right atrial hemangiosarcoma and pulmonary and hepatic metastasis. Fine needle aspiration from liver could confirm the diagnosis on this dog. Surgical resection of the mass and chemotherapy can improve survival time on these patients, but prognosis is poor on advanced disease.