Echocardiographic Demonstration of Bilateral Atrial Myxomas

Fitterer, J.D.; Spicer, Melvin J.; Nelson, William P.

doi:10.1378/chest.70.2.282

Cited by 18 publications

(7 citation statements)

References 17 publications

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“…Since the early reports of Wolfe et al (1969) andNasser et al (1972) (case 8) the ultrasound patterns have been well outlined: a mass of diastolic echoes is located in the right ventricle, posteriorly to the anterior tricuspid leaflet. Identical findings were reported by Goldschlager et al (1972), Feigenbaum andChang (1972), Harbold and Gau (1973) (Zajtchuk et al, 1975;Fitterer et al, 1976), and prolapse of the mitral valve (Meyers et al, 1977). These facts emphasise the importance of using ultrasound to explore all chambers of the heart.…”

Section: Discussionsupporting

confidence: 76%

Right atrial myxoma: an echocardiographic study.

Pernod¹,

Piwnica²,

Duret³

1978

Heart

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SUMMARY A case of right atrial myxoma is reported in a 29-year-old man. Though it was a large tumour, the diagnosis remained unsuspected for a long time.Multiple echo recordings strongly contributed to the diagnosis. After surgical removal, the postoperative course was uneventful.Since Banhson and Newman first described surgical removal of a right atrial myxoma, the importance of the recognition of these tumours has been widely emphasised.This report presents a case where echocardiography proved very useful in establishing the diagnosis. Case report A 29-year-old man was referred to the cardiological department in October 1976, for worsening dyspnoea and arthralgia.The past history disclosed that for 18 months he had been complaining of cough, palpitation, and fever (37.5-38°C); on chest x-ray examination, the heart was enlarged and the electrocardiogram showed ST-T changes; he was thus thought to have pericarditis and underwent biopsy of the pericardium which showed only non-specific fibrosis.On admission, his blood pressure was 130/80 mm Hg. Neck veins were not distended. A grade 2/6 protosystolic murmur and a grade 2/6 diastolic murmur were heard at the left sternal border; both were increased by inspiration.The electrocardiogram showed sinus rhythm, incomplete right bundle-branch block, and diffuse ST-T changes. The chest film showed cardiomegaly with right ventricular enlargement.The laboratory findings were a high erythrocyte sedimentation rate (35 mm in 1 hr, Wintrobe) and a white blood cell count of 13 200 with 80 per cent neutrophils. The other blood chemistry values were within the normal range.Echocardiography was then performed (Echeovideorex-CGR-2-25 MHz.) Fig. 1 shows intracardiac echoes, anterior to a 20] normal aorta, and originating from the right ventricular outflow tract, which are recorded by a beam passing through the aortic root. These echoes were identified only during the second part of diastole. An M mode-scan (Fig. 2) shows the right ventricular diastolic echoes which are identified in the mitral as well as in the aortic recordings. Left heart echograms are normal.Right heart catheterisation was also performed. The shape of the right atrial pressure curve suggested tricuspid regurgitation (giant v wave); the mean pressure was 9 mmHg and increased to 17 mmHg during compression of the liver. The right ventricular pressure was 25/0-5 mmHg.Cineangiographic studies with injection into the inferior vena cava showed a filling defect within the right atrium ( Fig. 3a and b). The mass was seen to prolapse into the right ventricle during ventricular diastole and return into the right atrium near the inferior vena cava during ventricular systole.With a presumptive diagnosis of right atrial myxoma, the patient was submitted to open-heart surgery. Operative findings consisted of a large myxoma attached to the interatrial septum between the inferior vena cava and the coronary sinus orifices by a stalk 2 mm in length. The tumour was removed and an associated dilatation of the tricuspid orifice was cor...

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Section: Discussionsupporting

confidence: 76%

Right atrial myxoma: an echocardiographic study.

Pernod¹,

Piwnica²,

Duret³

1978

Heart

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“…The friction rub noted in this case is an uncommon ausculatory finding. It has been suggested that this is caused by movement of the myxoma against the endocardium (Frankenfeld, Waters and Steiner, 1960). There was no ECGG nor echocardiographic evidence of pericarditis.…”

Section: Discussionmentioning

confidence: 97%

“…About 75% of myxomas are found in the left atrium, 20% in the right atrium and 5% in the ventricles (Goodwin, 1963). Although there have been twenty-two reported cases of biatrial myxomas (Sutton et al, 1980;Imperio et al, 1980;Fitterer, Spicer and Nelson, 1976;Herpin et al, 1980;Carvalho et al, 1980), the majority of these were not diagnosed until autopsy, or unexpectedly at exploratory surgery.…”

Section: Introductionmentioning

confidence: 99%

Bi-atrial myxomas presenting as recurrent pulmonary emboli in a girl

Hanly

Buitleir

Shaw

et al. 1984

Postgraduate Medical Journal

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SummaryA 14-year-old girl whose sole presenting features were symptoms of pulmonary embolism, was found to have bi-atrial myxomas. The diagnosis was made preoperatively, and the patient had a successful outcome following elective surgery. The absence of other features such as systemic embolism, atrioventricular valvular obstruction, fever and constitutional symptoms makes this a most unusual case. Right atrial myxoma should be considered in any patient presenting with pulmonary embolism for which there is no obvious source.

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“…They can be found in the right atrium 18% of the time, and 4% of the time in each of the right and left ventricles [1,20]. Myxomas can occur as biatrial tumors, or rarely as mul tiple tumors simultaneously occurring at dif ferent areas of the heart [20,21]. The myxo mas we encountered were all large solitary left atrial tumors, measuring 5-9 cm in diameter, with a mean of 6.5 cm.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Myxoma – Manifestations and Management: Kuwait Experience and Review of the Literature

Uthaman

Salama²,

Hayat

et al. 1996

Med Principles Pract

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Over the past 14 years, 12 patients were diagnosed as having cardiac myxoma. All cases were sporadic, single, large, left atrial myxomas. These patients presented with nonspecific cardiac and noncardiac manifestations. The majority were misdiagnosed as valvar heart disease at initial evaluation, although echocardiography confirmed the diagnosis of myxoma in all. Prompt surgical excision of the tumor was carried out in 11 patients. Additionally, one of them underwent mitral valve repair. This patient died postoperatively due to a coronary embolism, and reoperation. One patient refused surgery. Of the 10 surviving patients who had operations, 9 remain asymptomatic and in sinus rhythm, while 1 has progressive mitral regurgitation and cardiac failure. Our experience indicates that prompt tumor excision under transesophageal echo guidance, shortly after diagnosis, yields excellent results with low morbidity and mortality.

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Echocardiographic Demonstration of Bilateral Atrial Myxomas

Cited by 18 publications

References 17 publications

Right atrial myxoma: an echocardiographic study.

Right atrial myxoma: an echocardiographic study.

Bi-atrial myxomas presenting as recurrent pulmonary emboli in a girl

Cardiac Myxoma – Manifestations and Management: Kuwait Experience and Review of the Literature

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Echocardiographic Demonstration of Bilateral Atrial Myxomas

Cited by 18 publications

References 17 publications

Right atrial myxoma: an echocardiographic study.

Right atrial myxoma: an echocardiographic study.

Bi-atrial myxomas presenting as recurrent pulmonary emboli in a girl

Cardiac Myxoma &ndash; Manifestations and Management: Kuwait Experience and Review of the Literature

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Resources

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Cardiac Myxoma – Manifestations and Management: Kuwait Experience and Review of the Literature