A Case Presentation Based on Incidental Diagnosis of Atrial Myxoma in a Patient Presenting With Atrial Fibrillation and Suspected Carney Complex

Abstract

We present the case of a 54-year-old lady who presented to hospital with palpitations and was diagnosed with atrial fibrillation with rapid ventricular response. She was given intravenous metoprolol 5 mg initially followed by a further 5 mg and was commenced on bisoprolol 2.5 mg once daily. She reverted back to normal sinus rhythm and was referred for echocardiography following an episode of paroxysmal atrial fibrillation. The echocardiogram showed a large mobile atrial myxoma in the left atrium and mild-to-moderate mitral regurgitation with preserved left ventricular function. Her past medical history includes transsphenoidal surgery for acromegaly in 1979, followed by radiotherapy and partial thyroidectomy for goitre. Her chest radiograph was normal and blood results were unremarkable. She was accepted for inpatient transfer to a cardiothoracic centre for surgical removal of atrial myxoma. She underwent surgery with successful excision of the atrial myxoma, and biopsies confirmed the mass to be atrial myxoma. The surgery was complicated by the patient developing atrial fibrillation with fast ventricular response that was chemically cardioverted with an intravenous loading dose of amiodarone 300 mg over 2 hours followed by 900 mg infusion over 24 hours. She had follow-up in the outpatient clinic with cardiology and endocrine specialists for a year and no recurrence of myxoma was noted. Her blood tests including growth hormone and thyroid function tests were normal.

Carney complex- why thorough medical history taking is so important - report of three cases and review of the literature

“…3, even though key features of the disease were present much earlier. Such a long time to diagnosis is also reported in numerous case presentations of CNC [ 4 – 6 , 24 , 25 ]. Interestingly, the meaning of a detailed enquiry of the index patient and other family members is not discussed in most reports.…”

Misattribution of Dyspnea: Unveiling Atrial Myxoma as the True Culprit

“…A pathway that is clearly in favor of surgical intervention is the therapeutic management of an atrial myxoma, with complete removal of the tumor being the main goal [ 9 ]. Regarding the surgical intervention, the patient has just gone on symptomatic and electrocardiographic resolution and returned to normal cardiac functioning, indicating that the approach is effective.…”

A Case Report on the Incidental Diagnosis of a Left Atrial Myxoma in a Patient Presenting With Right Shoulder Pain and Inter-scapular Back Pain

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