Our case was initially admitted with presumptive diagnosis of Non-ST elevated myocardial infarction in congestive heart failure and was later found to have large left atrial (LA) mass. Apart from complete echocardiography study, we took help of multimodality imaging to better characterise this LA mass.However we did not have a confirmed diagnosis. Cardiac surgery was performed and surprisingly revealed large LA mass with pockets of fresh blood inside LA. Pathological specimen confirmed the presence of hematoma ruling out other atrial neoplasms. Though contrast echocardiography and cardiac magnetic resonance imaging were closest to intra-operative diagnoses, In the absence of any pre-disposing factors, final diagnosis was made at surgery and histopathological diagnosis.