Point-of-care Ultrasound: A Window into the Diagnosis of Atrial Myxoma in Stroke-like Patient

Abstract

Abstract Cardiac myxoma, the most common primary cardiac tumor, is indeed rare, with an estimated incidence of 0.03% in the general population. Despite its rarity, it can lead to severe complications such as intracardiac obstruction, emboli, and constitutional symptoms. Surgical excision of myxomas is associated with excellent outcomes and low rate of recurrence. Herein, we will report a case where the lesion was discovered early by point-of-care ultrasound (POCUS), allowing for the quickest possible prompt intervention. A 45-year-old man presented with a 1-day history of dizziness, right-sided body weakness, and facial asymmetry, which led to a motorbike fall. POCUS performed noted mass-like lesions measuring 7 cm by 6 cm, moving freely in the left atrium and prolapsing through the mitral valve during each cardiac cycle. The lesion appears to originate from the septal rather than the atrial appendage, which gives rise to a higher suspicion toward the left atrial myxoma than the left atrial thrombus. Besides, there are areas of liquefaction seen within the mass. He underwent a sternotomy and excision of the left atrial myxoma within the same hospitalization. Histopathology examination of the excised lesion confirmed the diagnosis of atrial myxoma. Early detection and surgical intervention result in a favorable prognosis. Upon discharge, he was stable, ambulating independently with minimal residual facial asymmetry.