Which of the following statements most accurately describes the structure and location of the coumadin ridge?
	1. It is a ridge of tissue separating the right atrial appendage from the right atrium
	2. It is a mass like lesion characteristically attached to the interatrial septum
	3. It is a thin flap which originates from the orifice of the inferior vena cava
	4. It is a thin ridge of tissue separating the left atrial appendage from the left upper pulmonary vein
	5. It is a thrombus which is located in the left ventricular apex

The correct answer for the question "Which of the following statements most accurately describes the structure and location of the coumadin ridge?" is:

4. It is a thin ridge of tissue separating the left atrial appendage from the left upper pulmonary vein

The coumadin ridge has been described as a ridge of atrial tissue separating the left atrial appendage from the left upper pulmonary vein. In the past, this structure was often mistaken for thrombus and resulted in patient being prescribed anticoagulation therapy with warfarin (Coumadin) and it is from here that it derives its name. The crista terminalis separates the right atrial appendage from the right atrium and the Eustachian valve is a thin flap-like structure that originates from the orifice of the inferior vena cava. The inter-atrial septum is usually the site for lipomatous hypertrophy or left atrial myxoma.

From the manuscript:
The Coumadin Ridge: An Important Example of a Left Atrial Pseudotumour demonstrated by Cardiovascular Magnetic Resonance Imaging
Radiology Case. 2009 Sep; 3(9):1-5

This article belongs to the Cardiac section.

From the manuscript

The Coumadin Ridge: An Important Example of a Left Atrial Pseudotumour demonstrated by Cardiovascular Magnetic Resonance Imaging
Abstract

The Coumadin Ridge: An Important Example of a Left Atrial Pseudotumour demonstrated by Cardiovascular Magnetic Resonance Imaging A coumadin ridge is an occasionally observed, but seldom described structure seen in the left atrium during cardiac magnetic resonance (CMR) imaging. In this case, the coumadin ridge was particularly prominent and could easily have been mistaken for a tumour or thrombus. Using the combined assessment from different CMR pulse sequences, we were able to correctly identify it as the coumadin ridge. We make the reader aware of the location and the CMR imaging features of this structure so that misdiagnosis may be avoided.

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