Diagnostic evaluation of cardiac masses remains challenging due to their broad etiological diversity and complex presentation. Multimodal imaging plays a central role, enabling precise lesion characterization, guiding therapeutic strategy, and improving prognosis. This presentation illustrates the complementary integration of echocardiography, cardiac CT, and cardiac MRI in the structured assessment of cardiac masses, through two illustrative clinical cases.

Echocardiography typically represents the first diagnostic step, offering rapid, dynamic, non-invasive assessment of mass location, mobility, and hemodynamic impact. Cardiac CT provides precise evaluation of calcifications, vascular supply, and anatomical relationships, particularly valuable for infiltrative or pseudo-tumoral lesions. Cardiac MRI adds advanced tissue characterization through late gadolinium enhancement and T1/T2 mapping, helping differentiate benign tumors, malignant tumors, and thrombus.

The first case describes a 6-cm pseudoaneurysm of the left anterior descending artery, successfully treated with a covered stent. The second case presents a cardiac paraganglioma, in which MRI tissue characterization was key to diagnosis and surgical planning. These two cases highlight the decisive role of a multimodal, case-based imaging approach in reducing diagnostic uncertainty and optimizing therapeutic decision-making, reinforcing multimodal imaging as a reliable strategy for cardiac mass evaluation.

Mohamed Amine Salem is an Assistant Professor and Specialist in Cardiology, Interventional Cardiology, and Vascular Medicine at Mustapha Bacha University Hospital in Algiers, Algeria. With over a decade of clinical and interventional practice, he specializes in general cardiology, cardiovascular imaging (echocardiography, vascular duplex), exercise testing, and complex endovascular and coronary interventions.

He serves as the Treasurer and Founding Member of the Algerian Cardio-Oncology Foundation (ACOF). He has authored and co-authored numerous peer-reviewed articles and medical books, including contributions to practical handbooks on cardiovascular emergencies and electrocardiography. He is an active speaker and presenter at national and international cardiology congresses, focusing on complex PCI, structural heart interventions, and vascular care.