|Year : 2015 | Volume
| Issue : 4 | Page : 101-102
Case Report of a Rare Benign Cardiac Tumor: Atrial Myxoma
Thabish Syed, Dilip Ahir, Mahesh Kumar Gupta, Avneesh Prasad
Department of Medicine, NIMS Medical College, Jaipur, Rajasthan, India
|Date of Web Publication||21-Dec-2015|
Post Graduate in Medicine, NIMS Medical College, Jaipur, 303121, Rajasthan
Source of Support: None, Conflict of Interest: None
We report a rare case of benign cardiac tumor - atrial myxoma - who completely recovered after surgery.
Keywords: Atrial myxoma, cardiac tumour, trepopnea
|How to cite this article:|
Syed T, Ahir D, Gupta MK, Prasad A. Case Report of a Rare Benign Cardiac Tumor: Atrial Myxoma. Heart India 2015;3:101-2
| Introduction|| |
Atrial myxomas are the most common benign primary cardiac tumors.  They arise most commonly from the left atrium. Myxomas are more common in women around 40-60 years of age. , Their presentation varies from completely asymptomatic to dangerous myocardial infarction due to emboli from tumor mass. Surgery is the treatment of choice with good prognosis. 
| Case Report|| |
A 35-year-old female patient presented to the cardiology outpatient department (OPD) with complaints of shortness of breath since 1 year and one episode of syncopal attack 3 days back. The patient gave a typical history of breathlessness in the standing position (trepopnea), along with palpitations and generalized weakness.
On examination, her vitals were stable. Systemic examination of the cardiovascular system (CVS) revealed systolic murmur and mid-diastolic murmur (tumor plop) over the apex; S1 was loud and there was inspiratory split in S2.
On investigating the patient, her blood count and liver and renal function tests were normal. Electrocardiogram (ECG) and chest x-ray (CX-Ray) showed left atrial abnormality and right ventricular hypertrophy. Two-dimensional (2D) echocardiography (echo) revealed a mass in the left atrium [Figure 1]. Hence, the diagnosis of atrial myxoma was confirmed based on the history, clinical features, and noninvasive diagnostic tests such as 2D echo and biopsy of the tissue sample. Eventually after stabilizing the patient, we performed surgery and at present her breathlessness has improved and her auscultatory findings have completely improved.
|Figure 1: 2D echo image suggestive of left atrial mass- atrial myxoma patient image|
Click here to view
| Discussion|| |
Atrial myxomas are the most common of all cardiac tumors;  the most common site of its origin is the left atrium near fossa ovalis. Its diagnostic mode of choice is echo.  Although characteristically benign, it can embolize to the coronary arteries and presents with acute myocardial infarction and cerebral infarction.  Sometimes, myxomas present with severe left ventricle dysfunction, thus leading to effort intolerance.  Surgical management is the treatment of choice with good prognosis.  Recurrence of myxoma is very rare. 
| Conclusion|| |
Atrial myxoma is a rare benign cardiac tumor presenting with various signs and symptoms; its spectrum varies from completely asymptomatic to life-threatening events due to embolic phenomenon and obstruction of mitral valve. Early diagnosis and timely surgical management give the patient a completely asymptomatic life as recurrences are extremely rare.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Cannavà G, Currò A. Left atrial myxoma presenting as acute coronary syndrome. Int J Cardiol 2015;190:148-50.
Layton S, Ripley DP, Bellenger NG. Left atrial myxoma. BMJ 2013;347:f4430.
Ekmektzoglou KA, Samelis GF, Xanthos T. Heart and tumors: Location, metastasis, clinical manifestations, diagnostic approaches and theraupeutic considerations. J Cardiovasc Med (Hagerstown) 2008;9:769-77.
Facchin L, Tenderini PL, Caturelli G. Integrated echocardiography (transthoracic-transesophageal) in the differential diagnosis of left atrial myxoma. Description of three clinical cases. Cardiologia 1998;43:515-8.
Hashimoto H, Takahashi H, Fujiwara Y, Joh T, Tomino T. Acute myocardial infarction due to coronary embolization from left atrial myxoma. JPN Circ J 1993;57:1016-20.
Chockalingam A, Jaganathan V, Gnanavelu G, Dorairajan S, Chockalingam V. Severe left ventricular dysfunction in left atrial myxoma - report of 2 cases. Angiology 2006;57:119-22.
Bahl OP, Oliver GC, Ferguson TB, Schad N, Parker BM. Recurrent left atrial myxoma. Report of a case. Circulation 1969;40:673-6.