The mimetic nature of left atrial myxomas: Report of a case presenting as a severe systemic illness and simulating massive mitral insufficiency at cardiac catheterization

Abstract

A case of left atrial myxoma presenting the features of a severe systemic disease is described. Transseptal catheterization revealed left atrial hypertension and an enormous V peak. These hemodynamic alterations are ascribed in part to a mechanically inefficient atrial diastole produced by the huge myxomatous mass but more importantly to massive mitral insufficiency which may be created by herniation of the tumor through the mitral valve orifice. It is emphasized that left atrial myxomas may produce the signs of a multisystemic disease in the absence of embolic phenomena. The etiology of this diffuse response is unknown. A systemic reaction to the degenerative changes in the tumor is an attractive hypothesis. Recognition of the varied clinical manifestations of left atrial myxomas and greater suspicion of the presence of this lesion will indicate the need for more immediate and definitive angiocardiographic study in cases of obscure heart disease.