Left Atrial Myxoma Presenting Research Articles

Clinical presentation of left atrial cardiac myxoma. A series of 112 consecutive cases.

We analyzed a series of 112 consecutive cases of left atrial myxoma diagnosed in a single French hospital (72 women and 40 men; age range, 5-84 yr) over 40 years, from 1959 to 1998. Symptoms of mitral valve obstruction, the first arm of the classic triad of myxoma presentation, were present in 75 patients (67%), with mostly cardiac failure or malaise. Symptoms of embolism, the second frequent presentation in the classic triad, were observed in 33 cases (29%) with 1 or several locations, essentially cerebral emboli with stroke. Males are statistically at greater risk than females of developing embolic complications. The third arm of the classic triad consists of constitutional symptoms (34%) with fever, weight loss, or symptoms resembling connective tissue disease, due to cytokine (interleukin-6) secretion. Younger and male patients have more neurologic symptoms, and female patients have more systemic symptoms. Seventy-two patients (64%) had cardiac auscultation abnormalities, essentially pseudo-mitral valve disease (53.5%) and more rarely the suggestive tumor plop (15%). The most frequent electrocardiographic sign was left atrial hypertrophy (35%), whereas arrhythmias were uncommon. The greater number of myxoma patients (98) diagnosed preoperatively after 1977 reflects the introduction of echocardiography as a noninvasive diagnostic procedure. However, there was no significant reduction in the average time from onset of symptoms to operation between patients seen in the periods before and after 1977. The tumor diameter ranged from 1 to 15 cm with a weight of between 15 and 180 g (mean, 37 g). The myxoma surface was friable or villous in 35% of the cases, and smooth in the other 65% cases. Myxomas in patients presenting with embolism have a friable surface; those in patients with cardiac symptoms, pseudo-mitral auscultation signs, tumor plop, and electrocardiogram or radiologic signs of left atrium hypertrophy and dilatation are significantly the larger tumors. The long-term prognosis is excellent, and only 4 deaths occurred among our 112 cases over a median follow-up of 3 years. The recurrence rate is low (5%), but long-term follow-up and serial echocardiography are advisable especially for young patients.

A Case of Left Atrial Myxoma Presenting as Acute Pulmonary Edema

Myxomas are the most common primary benign cardiac tumor. In general, myxoma has a benign growth and chronic entity, so symtoms of myxoma are vague and mild. Therefore the association of an atrial myxoma with acute pulmonary edema and syncope appears to be very rare. Even though very rare, detection of myxoma is important because it is usually fatal in several cases if unrecognized and untreated. We experienced a case of left atrial (LA) myxoma presenting as acute pulmonary edema and syncope of unknown cause in 47 years old female patient. A mass located on left atrium was excised en bloc, and the patient recovered uneventfully. We report the case along with literature review.

A left atrial myxoma presenting as a cerebrovascular accident

A 14-year-old female presented with common clinical findings for a rare primary intracardiac tumor. Primary cardiac tumors are rare in all age groups, occurring in 0.05% of routine postmortem examinations. Pediatric primary cardiac tumors are likewise uncommon, with the most common being a rhabdomyoma. Atrial myxomas occur infrequently in the pediatric age group. They occur primarily between the third and sixth decade, making them the most common adult primary cardiac tumor. The following case presentation demonstrates a common clinical presentation for an intracardiac mass rarely diagnosed in the pediatric population. This patient’s acute neurologic symptoms required prompt recognition of an intracardiac etiology. This recognition proved critical for the acute and long-term medical and surgical management of this patient.

Left atrial myxoma presenting with myocardial infarction: Case report and review of the literature

Coronary artery embolization is an extremely rare and potentially lethal complication of atrial myxomas. We present a case report and a literature review of this clinical association. A 53-year-old woman presented with an acute infero-lateral myocardial infarction. Coronary angiography performed 1 h after the onset of pain disclosed an abrupt stop and multiple embolization of the peripheral right coronary artery (RCA). A transthoracic echocardiographic study revealed the presence in the left atrium of an echogenic, mobile mass, compatible with myxoma. The tumour was successfully removed surgically 2 weeks later and the patient is doing well one year post operatively.

Left atrial myxoma presenting with embolism to the aorta

We present a patient with left atrial myxoma embolizing to the ascending aorta. The features have not been reported previously and were diagnosed with transesophageal echocardiography. (J Am Soc Echocardiogr 1997;10:381-3.)

Bacterial endocarditis as an unusual presentation of left atrial myxoma

A 72-year-old woman presented with chronic febrile illness and enterococcal bacteraemia, and after a series of exhaustive tests, was shown to have a left atrial mass on transoesophageal echocardiography. Successful resection of the atrial myxoma resulted in full recovery and discharge from hospital. The clinical features and investigative approach are discussed in relation to a review of the literature.

Left Atrial Myxoma Presenting as Acute Respiratory Failure

We report the unusual case of a young man with acute respiratory failure caused by a left atrial myxoma. The patient's rapid clinical deterioration and severe hypoxemia suggested the acute respiratory distress syndrome; however, unexpected physical examination findings and a markedly elevated pulmonary capillary wedge pressure implied cardiac abnormality. The use of echocardiography as a bedside tool allowed correct, rapid diagnosis.

Transient loss of peripheral vision as the presentation of left atrial myxoma.

A 42-year-old man developed transient loss of vision in both eyes. On echocardiography to investigate a systolic murmur and determine the potential source of emboli, a large left atrial myxoma was diagnosed. This was removed successfully leaving no visual or neurological deficit.

Left atrial myxoma presenting as acute myocardial infarction.

A 58-year-old man with left atrial myxoma complicated with acute myocardial infarction is presented. On coronary arteriography, 50% stenosis and a saccular aneurysm was found just below the stenosis at segment 1 of the right coronary artery. Ergonovine provocation study was negative. It was proposed that the myocardial infarction probably was caused by coronary embolization from the left atrial myxoma.

Saddle Embolus as First Presentation of Left Atrial Myxoma in a 14-Year-Old Girl

A 14-year-old girl was brought to the A & E department minutes after collapsing while out walking minutes earlier. She had developed sudden, severe, cramping pain in her lower abdomen and both legs, and had been incontinent of urine. Earlier that day she had an episode of diarrhoea. The girl was previously in excellent health.

Recurrent left atrial myxoma presenting as peripheral arterial embolus

Recurrence of left atrial myxoma is rare. A male aged 18 years developed recurrence of left atrial myxoma despite excision of the tumour along with an ample cuff of the atrial septum around the tumour stalk, two years earlier. The patient presented with peripheral arterial embolus and underwent right femoropopliteal embolectomy and excision of the recurrent atrial myxoma. The presentation of recurrent left atrial myxoma with peripheral arterial embolism has perhaps not been reported earlier. Etiopathology of recurrence of myxomas and surgical treatment are discussed.

Left atrial myxoma presenting with synchronous carotid and femoral embolism

Synchronous embolism of the right femoral and the left internal carotid arteries, occurring in a 39-year-old teacher upon physical effort, was found to be due to a left atrial myxoma. Clinical findings, electrocardiogram and chest radiographs had suggested myocarditis. The patient died of cerebral infarction. In cases of suspected myocarditis, left atrial myxoma has to be considered in the differential diagnosis. Histological examination is recommended of any material obtained by embolectomy.

Left Atrial Myxoma Presenting With Intermittent Claudication and Raynaud's Phenomenon: Echocardiographic Patterns of the Tumor Size

Left Atrial Myxoma Presenting With Intermittent Claudication and Raynaud's Phenomenon: Echocardiographic Patterns of the Tumor Size

Unusual echographic manifestations of right and left heart myxomas

Although echocardiography has provided a useful noninvasive means for detecting cardiac myxomas, the ultrasound manifestations of these tumors may be variable. We describe our experiences with unusual echographic features encountered in left and right heart myxomas. Thus the left atrial tumor may be manifested predominantly by multiple, discrete, linear echoes behind the mitral valve, the anterior leaflet of which may exhibit an abrupt mid-systolic posterior movement. In right heart myxomatous tumor arising from the septal tricuspid leaflet and adjacent interventricular septum, the echographic characteristics include a cloud of echoes throughout the cardiac cycle in the right ventricular outflow tract which are present in the right ventricle body only during relaxation and are anterior to the tricuspid valve in early diastole. Therefore, discrete linear echoes may be the principal echographic presentation of left atrial myxoma, and special attention should be focused on all areas of the tricuspid valve and right ventricle by ultrasound in patients in whom diagnosis of myxoma is suspected.

Left Atrial Myxoma Presenting as Rheumatic Fever

A 12-year-old girl, with a diagnosis of previous rheumatic fever and murmur of mitral insufficiency, is reported. Echocardiographic examination was performed to assess mitral valve function. Documentation of left atrial myxoma and its subsequent growth over a three-month period was recorded.

Entire left atrial myxoma presenting as a saddle embolus.

A case is presented in which a complete left atrial myxoma became detached and lodged in the aortic bifurcation. Shortly after it had been removed the patient suffered cardiac arrest and could not be revived.