Successful surgical treatment of a right atrial myxoma complicated by pulmonary embolism (original) (raw)
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Right Atrial Myxoma with Pulmonary Embolism
Cardiology, 1994
Primary cardiac tumors are rare with an autopsy incidence ranging from 0.0017~0.05%. Right atrial myxoma is one of the rarest of primary cardiac tumors and a tumor type that is difficult to diagnose. The most common fatal complication is pulmonary embolism from tumor fragments originating from the tumor mass. Thus early diagnosis of cardiac myxoma is important. The surgical excision of atriac myxoma would appear to elicit excellent short-term and long-term results. Here we report a 68 years old female who was admitted to regional hospital for investigation of chest pain and dyspnea, both of which arose suddenly six days prior to her admission to our hospital. Subsequent to a comprehensive medical investigation, a right atrial myxoma with pulmonary embolism was diagnosed for this patient. Emergency surgery including right atrial myxoma excision and pulmonary embolectomy was performed, with subsequent excellent results for this patient.
Pulmonary embolism due to the right atrial myxoma
Collegium antropologicum, 2006
A 47-year-old man was admitted to the hospital with a pleuritic pain, dyspnea, nonproductive cough and low-grade fever. An ECG documented a sinus tachycardia with S1Q3T3 pattern and incomplete right bundle branch block, and lung scintigraphy showed multiple perfusion defects. The initial diagnosis was pulmonary embolism. Echocardiography, undertaken before application of the anticoagulant therapy because of hematological disturbances reflecting possible coagulopathy (elevated erythrocyte sedimentation rate, increased leukocyte count, decreased platelet count), revealed a large mobile tumor in the right atrium. Tumor was surgically removed, and histological findings was supported a diagnosis of the cardiac myxoma. The right cardiac myxoma should be considered in the differential diagnosis of pulmonary embolism, particularly in cases presented in conjunction with constitutional symptoms and/or hematological disturbances. In these patients echocardiography should be undertaken early to...
A case report of atrial myxoma presenting with systemic embolization and myocardial infarction
European Heart Journal - Case Reports, 2019
Background Cardiac myxomas are the most common benign primary tumour of the heart. Clinical presentation is variable and ranges from constitutional symptoms to clinical features due to intracardiac obstruction, such as mitral stenosis, coronary embolization, or systemic embolization. Surgical resection is the only effective treatment to prevent its debilitating and catastrophic complication. Case summary A 61-year-old woman presented with an-hour history of bilateral leg pain, numbness, lightheadedness, dyspnoea, and diaphoresis. Physical exam was remarkable for pale and cold lower extremities. Arterial pulse was not palpable in the right femoral, popliteal, and posterior tibial and dorsalis pedis arteries bilaterally. Electrocardiogram demonstrated normal sinus rhythm with T-wave inversion in lead I, V2, V3, and V4. Laboratory investigations were remarkable for leucocytosis and elevated troponin. Computed tomography angiogram showed emboli with acute infarcts involving the spleen a...
Massive right atrial myxoma with dyspnea at rest in an elderly patient: A case report
Vojnosanitetski pregled, 2015
Introduction. Primary heart tumors are extremely rare and myxoma is the most common type of these tumors. Although intraatrial presentation is a predilection place, right atrial localization is atypical. The symptom triad is characteristic in the clinical presentation of the tumor: embolic complication, intracardiac blood flow obstruction and systemic manifestations like elevated erythrocyte sedimentation rate, fever, anemia, body weight loss. Case report. We presented an elderly female patient with massive myxoma in the right atrium, 77 ? 44 mm in diameter, which filled the entire right atrium and spread into the right ventricle, causing the tricuspid valve obstruction and dyspnea. It was visualized by transthoracic echocardiography and small and insignificant pericardial effusion was also seen. After surgical removal of the tumor, the patient remained without any symptoms and pericardial effusion. Conclusion. Tumors of the right heart have to be considered in the differential diag...
Pathology International, 2003
Nonfamilial myxoma occurs as a random event. The tumor is rare and can mimic other diseases. Cardiac myxomas should always be considered as a source of embolization, which need meticulous investigation and prompt indication of surgical resection. Tumors with a villous surface are prone to embolize. We report two cases of cardiac myxoma presenting as acute ischemia of one or two limbs due to embolic phenomena. The patients were females aged 55 and 37 years. Histological study of emboli taken from obstructed limb arteries in the two patients showed a picture indicating systemic embolization of a cardiac myxoma. The embolic tissue fragments showed the gross characteristics (i.e. villous surface) of the cardiac tumor. Further echocardiography and surgical removal confirmed the cardiac myxoma. Immunohistochemical study of embolectomy material disclosed strong reactivity of the tumor cells for calretinin. The histological examination of the embolectomy material can anticipate the cardiac lesion and its gross features. Calretinin is a useful marker in the differential diagnosis of cardiac myxoma with a myxoid thrombus. The necessity of histological examination of the embolectomy material is stressed.
Giant left atrial myxoma in an elderly patient: Natural history over a 7-year period
Journal of Clinical Ultrasound, 2006
We present the case of a 71-year-old woman with a 7-year history of a giant left atrial myxoma. The myxoma was attached to the atrial septum and occupied almost the entire left atrial cavity. The patient was hospitalized 4 times because of dyspnea on exertion, palpitations, fatigue, general asthenia, and weight loss. During prior hospitalizations, the patient had refused cardiac surgery. She developed several complications, including atrial fibrillation, mitral and tricuspid regurgitation, mesenteric embolism, pulmonary edema, and thrombotic stroke. We herein describe the natural history of left atrial myxoma in an elderly patient over a 7-year period.
Fifteen-year experience in the surgical management of right atrial myxoma
Cardiothoracic and Vascular Sciences, 2017
Objective: This study presents our experience with the clinical presentation, tumor characteristics, surgical management and post-operative outcomes of patients operated for right atrial myxoma. Methods: A retrospective analysis of all patients diagnosed with right atrial myxoma in our center from years 2000 to 2015 was conducted. All data were gathered from medical records following board approval. Twelve cases were identified, eight of which were female. Data is reported as frequencies, percentages, averages and ranges. Results: Clinical presentation proved very heterogeneous amongst our group. The most common finding was right-sided heart failure in 2 patients (17%). The average tumor size was 30mm and the most common attachment site was the inter-atrial septum. Myxomas were resected through median sternotomy or right thoracotomy. Post-operative morbidity includes dysrhythmias and tricuspid disease despite morphologically normal tricuspid structure in most cases. There was no perioperative mortality. Follow-up averaged 39 months and showed no recurrence. Conclusions: While surgical results for right atrial myxoma are satisfactory, its inconsistent presentation and rarity continue to pose a diagnostic challenge to clinicians who encounter it. Our data and review of literature identified right-sided heart failure, tricuspid regurgitation and pulmonary embolism as common findings in right atrial myxoma and lead us to suggest that clinicians consider it in their differential diagnosis in situations where such findings go unexplained.
Catastrophic systemic embolization from a left atrial myxoma
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2014
We report the fatal course of a left atrial myxoma: its systemic embolization to the coronary, cerebral, renal, and peripheral vascular beds in a 39-year-old woman resulted in rapid clinical deterioration, multiorgan failure, and death. Among reported cases of left atrial myxoma, this degree of embolic burden is exceedingly rare. In addition to reporting the patient's case, we discuss the presentation and diagnosis of possible intracardiac sources of systemic emboli.