Introduction:Left Atrial tumors are known to present in congestive heart failure by their propensity to block flow in the left heart. Myxomas are commoner of these tumors; however other tumors have to be considered. Left atrial myxomas warrant an emergency surgery, however a thorough workup is emphasized even in an emergency.Case Report: A 35 year lady presented to the emergency department with acute congestive heart failure. CXR showed cardiomegaly and florid pulmonary edema. An echocardiogram revealed a 43x33mmleft atrial myxoma (Charuzi class III) and pulmonary hypertension. Since she was too sick, for emergency surgery, medical stabilization was done. A repeat CXR showed clearing of pulmonary edema but also a persistent suspicious opacity in the left upper lung zone. Computed tomography of thorax revealed a mass extending from the arch of aorta into the left atrium and ventricle. Computed tomography guided needle biopsy of the mass showed presence of a primary synovial sarcoma.Conclusions: LA myxomas presenting with congestive heart failure often require emergency surgery. However through evaluation prior to surgery cannot be substituted. Presence of florid pulmonary edema on chest x-ray can mask other lung lesions especially metastasis. In such instances further investigations are necessary to make the correct diagnosis.
Introduction:Left Atrial tumors are known to present in congestive heart failure by their propensity to block flow in the left heart. Myxomas are commoner of these tumors; however other tumors have to be considered. Left atrial myxomas warrant an emergency surgery, however a thorough workup is emphasized even in an emergency.Case Report: A 35 year lady presented to the emergency department with acute congestive heart failure. CXR showed cardiomegaly and florid pulmonary edema. An echocardiogram revealed a 43x33mmleft atrial myxoma (Charuzi class III) and pulmonary hypertension. Since she was too sick, for emergency surgery, medical stabilization was done. A repeat CXR showed clearing of pulmonary edema but also a persistent suspicious opacity in the left upper lung zone. Computed tomography of thorax revealed a mass extending from the arch of aorta into the left atrium and ventricle. Computed tomography guided needle biopsy of the mass showed presence of a primary synovial sarcoma.Conclusions: LA myxomas presenting with congestive heart failure often require emergency surgery. However through evaluation prior to surgery cannot be substituted. Presence of florid pulmonary edema on chest x-ray can mask other lung lesions especially metastasis. In such instances further investigations are necessary to make the correct diagnosis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.