Primary cardiac tumours occur rarely with a reported incidence of 0.03 to 0.05 per cent. i Cardiac myxoma is the most common of these primary tumours. Review of the literature reveals little concerning the anaesthetic management of patients with cardiac myxoma. 2'3 We present a patient with a right atrial myxoma, hypoxaemia, and an episode ol severe hypotension during induction of anaesthesia as well as treatment. This is followed by a discussion of the anaesthetic considerations for the patient presenting with right atrial myxoma.
Case reportThe patient, a 67-year-old 63 kg male, was transferred to our institution because of progressive dyspnoea and severe hypoxaemia. These symptoms were noted four months earlier when he presented with a complaint of shortness of breath, diagnosed as bronchitis, and treated with aminophylline with no benefit. Past medical history revealed insulin-dependent diabetes mellitus. Laboratory reports included a haemoglobin of 170 g. L -], haematocrit of 50.4 per cent, and arterial blood gas values (ABG) breathing 100 per cent O2 via face mask of pH 7.46, PO2 45 mmHg, PCOz 21 mmHg, and O2 saturation of 87 per