Echocardiographic appearance of the Chiari network: differentiation from right-heart pathology.

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Abstract
Echocardiography provides the potential for identifying normal anatomic variants and their possible erroneous interpretation as pathologic states. The M-mode and 2-dimensional echocardiographic features of a congenital remnant known as the Chiari network is described. This structure can present as a highly mobile, highly reflectant echo target seen in several locations in the right atrium. An index case that could be well examined echocardiographically and that was a cause of considerable concern due to the presence of congestive heart failure and a history of staphylococcal endocarditis is presented. The presence of the Chiari network was confirmed pathologically. Similar echocardiographic findings were found in 19 of 1248 patients (1.5%) studied. This congenital remnant, which is found pathologically in 2-3% of normal hearts could be confused with valve disruption, vegetation or other mass lesion, particularly when associated with a suggestive clinical situation.