A 62-year-old lady was urgently transferred due to newly discovered coronary artery disease after cardiac arrest induced by spinal anaesthesia. Her medical history included hypertension, severe osteoporosis, and fracture of the shaft of the right tibia. Four days before admission, she fractured the neck of her right femur and was referred for dynamic hip screw fixation. During spinal anesthesia, she had a cardiac arrest and was successfully resuscitated. Coronary angiography revealed lesions in the left anterior descending, diagonal, and circumflex coronary arteries associated with a small aneurysm (Figure 1
); the right coronary was normal. Urgent myocardial revascularization was performed using an off-pump technique to graft the affected arteries using left internal mammary artery and saphenous vein grafts, followed by fixation of the intertrochanteric fracture. Intraoperatively, a mass was found originating from the left atrial appendage (Figure 2a
). Complete excision was performed (Figure 2b
). Histopathological examination was compatible with a cavernous hemangioma (Figure 3
). Hemangiomas are rare benign tumors of the heart with an incidence of 2% of all primary tumors. They commonly affect the left ventricle, right atrium, and right ventricle. Hemangioma arising from the left atrium is rare; only a few cases have been reported.