Diffuse cerebral embolism as the first manifestation of the right atrial myxoma

Abstract

Abstract Introduction Neurological complications in patients with diagnosed atrial myxoma occur in approximately 30% of cases. Aim The aim of this paper is to present the case of a female patient with right atrial myxoma and demonstrate neurological complications. Case study This paper presents the case of a 51-year-old female patient who was admitted to the hospital due to dizziness, nausea, vomiting and gait disorders lasting for two days. Head computed tomography (CT) showed vascular changes in the cerebellum and magnetic resonance imaging (MRI) of the brain revealed numerous synchronous, recent vascular diffuse foci in the left occipital lobe and left cerebellar hemisphere. Transthoracic echocardiography examination (TTE) detected the myxoma in the right atrium with the suspicion of atrial septal defect secundum (ASD2). The patient underwent a successful surgery to remove the right atrial myxoma. The procedure also revealed ASD2. Results and discussion Myxoma is one of the most common primary heart tumors and it accounts for about 50% of benign heart tumors; three out of four cases involve women. Most myxomas are localized in the left atrium and only approximately 18% are found in the right one. The symptoms of brain damage usually appear when the tumor is localized in the left atrium and rarely occur when the tumor involves the right atrium. In the presented case, during the procedure, the coexistence of ASD2, which may lead to crossed embolism, was confirmed. Conclusions The right atrial myxoma may manifest with neurological symptoms due to diffuse cerebral embolism.