Large multi lobulated right atrial mass attached to central venous catheter

Central venous catheters (CVC) are used commonly in clinical practice. Incidence of CVC related right atrial thrombus (CRAT) are variable. Different pathogenic mechanisms have been detected for the development of CRAT, which includes: mechanical irritation of myocardium, propagation of intraluminal clot, hypercoagulability. CRAT had different presentation, it may be asymptomatic or may be associated with one of the complications like pulmonary embolism, infected thrombus, systemic embolism .We report an interesting case of 27 years old man with history of end stage renal disease and hemodialysis with perm Cath which presented with fever and in his trans thoracic echocardiography revealed large right atrial mass.