A 50 year old female with Digital Ischemia and Raynaud's like phenomenon was referred. She had complained of fatigue, work up with ANA showed positive result, and her anti ds DNA was found to be strongly positive as well. Her renal function deranged (creatinine2.5). Ultrasound of the abdomen shows features suggestive of chronic liver disease, mild Ascites. Echo shows a mass in the right atrium roof.
We need a discussion here regarding her treatment management. Attached is an image showing RA mass in a modified apical 3 chambered view. Your opinion will be helpful.
