Giant left atrial myxoma presenting as acute myocardial infarction

Marta, Liliana; Peres, Marisa; Alves, Miguel; Silva, Graça Ferreira da

doi:10.1016/j.repce.2012.10.003

Cited by 8 publications

(10 citation statements)

References 4 publications

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“…Myxomas account for 50% of primary cardiac tumors; most are sporadic, and are found more commonly in women. 2,4 The most frequent location (75% -85%) is the left atrium, where they typically arise from the interatrial septum. Ninety percent of myxomas are pedunculated, with 2 morphologic patterns: round or polypoid.…”

Section: Discussionmentioning

confidence: 99%

“…Ninety percent of myxomas are pedunculated, with 2 morphologic patterns: round or polypoid. 2,4 There are 3 distinct groups of clinical manifestations. Constitutional symptoms, which have been attributed to tumoral cytokine production, include fatigue, fever, weight loss, and myalgias.…”

Section: Discussionmentioning

confidence: 99%

“…Atrioventricular valve obstruction can present with symptoms of mitral or tricuspid valve regurgitation or stenosis, and with left-or right-sided heart failure. 2,4 Finally, in up to 65% of left-sided myxomas, systemic embolization causes arterial occlusion and organ ischemia or infarction, which typically manifests itself as ischemic stroke or renal infarction. 2,4 However, the incidence of coronary embolization is only 0.06%, which might be explained by the perpendicular orientation of the coronary ostia to the aortic flow and to their consequent protection from the aortic leaf lets …”

Section: Discussionmentioning

confidence: 99%

“…2,[4][5][6][7] The right coronary artery is most often affected; however, embolization to the left anterior descending and left circumflex coronary arteries has also been reported. Systemic embolization is more frequently associated with polypoid tumors that have an irregular and friable surface, and with tumors that prolapse into the ventricle.…”

Section: E) Stains Positive For Ki67 and Pax5 Confirm B-cell Lymphomamentioning

confidence: 99%

“…2 Embolic causes must be suspected in patients who have otherwise healthy coronary arteries. We present the case of a 50-year-old man who presented with myocardial infarction due to an acute occlusion of the first obtuse marginal branch-most likely by a coronary embolus from a large mobile left atrial myxoma.…”

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Coronary Embolization from a Left Atrial Myxoma Containing Malignant Lymphoma Cells

Pineda¹,

Mihos²,

Nascimento³

et al. 2015

Texas Heart Institute Journal

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T he pathophysiology of an ST-segment-elevation myocardial infarction involves, in most cases, the rupture of an atherosclerotic plaque with superimposed thrombus formation.1 Cardiac tumors are among the possible embolic sources of coronary embolization, and can present with an acute myocardial infarction. Embolic causes must be suspected in patients who have otherwise healthy coronary arteries. We present the case of a 50-year-old man who presented with myocardial infarction due to an acute occlusion of the first obtuse marginal branch-most likely by a coronary embolus from a large mobile left atrial myxoma. In addition, a concomitant malignant lymphoma was found within the tumor. Case ReportA 50-year-old white man presented at the emergency department at our institution with a 1-hour history of severe retrosternal pain, dyspnea, and diaphoresis. His medical history was noteworthy for hypertension and dyslipidemia, both of which had been treated with diet and exercise, and there was no family history of coronary artery disease. He drank alcohol occasionally, and had no history of smoking or illicit-drug use. He reported no symptoms before the presentation, such as dyspnea on exertion, fever, night sweats, or weight loss. On presentation, his blood pressure was 148/92 mmHg; pulse, 102 beats/min; respiratory rate, 22 breaths/min; and oxygen saturation, 97%. The patient was anxious and diaphoretic, but the results of his cardiopulmonary examination were generally within normal limits, without murmurs or signs of congestive heart failure. The initial electrocardiogram (Fig. 1) showed inferolateral ST-segment elevation with reciprocal changes in the anteroseptal leads, so the patient was taken for emergency coronary angiography. His angiogram revealed an acute occlusion of the first obtuse marginal branch in its mid segment ( Fig. 2A), with otherwise normal coronary arteries. After an attempted aspiration recovered no débris, balloon angioplasty was performed, and a repeat angiogram showed no significant residual plaque or dissection at the level of the original occlusion; but it did reveal distal branch embolization (Fig. 2B). Therefore, an embolic source was suspected. The patient was admitted to the coronary care unit for further evaluation and conventional postinfarction management. His echocardiogram showed normal left ventricular (LV) function with no wall-motion abnormalities or valvular disease of substance; however, it revealed a large polypoid left atrial mass attached to the interatrial septum. Notably mobile and prolapsing into the LV, it was suspect for myxoma (Figs. 2C and D). In light of these findings, the patient underwent minimally invasive resection Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: E) Stains Positive For Ki67 and Pax5 Confirm B-cell Lymphomamentioning

confidence: 99%

mentioning

confidence: 99%

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Coronary Embolization from a Left Atrial Myxoma Containing Malignant Lymphoma Cells

Pineda¹,

Mihos²,

Nascimento³

et al. 2015

Texas Heart Institute Journal

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Acute heart failure related to a large left atrial myxoma

Chiariello

Bruno

Colizzi

et al. 2018

Baylor University Medical Center Proceedings

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An association between atrial myxoma and left ventricular failure is rarely described, is not completely understood, and may have multiple etiologies. We present a 49-year-old man with no history of cardiovascular disease who was admitted to our hospital with pulmonary edema. He was in atrial fibrillation with rapid ventricular response. Echocardiography showed a 10.5-cm left atrial myxoma, which had been asymptomatic until the onset of congestive heart failure in the presence of severe left ventricular systolic dysfunction. Left ventricular inflow obstruction associated with the giant atrial mass could not be the only cause for acute heart failure.

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Acute heart failure due to a giant left atrial myxoma: a case report

Alan

Andres

Antonio

2022

European Heart Journal - Case Reports

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Background Cardiac myxomas are the most common primary benign tumor of the heart. Most of them occur between the 4th and 6th decade of life, are most frequent in the woman, and most frequently localized in the left atrium Case summary We present a case of a 41-year-old female who presented with a history of left-sided heart failure. A left atrial mass of 87 × 88 × 65 mm was documented by cardiac magnetic resonance. She was taken to surgical resection of the mass. Histopathologic findings were diagnostic of cardiac myxoma. Generally, myxomas that are bigger than 6 cm are associated with the worst prognosis. Discussion Primary cardiac tumors are mostly benign, being in 50% of the cases a cardiac myxoma. The rest of them correspond to papillary fibroelastoma (26%), fibromas (6%), lipomas (4%), and others including calcified tumors, hemangiomas, teratomas, cysts, and rhabdomyomas. Our clinical case illustrates an unusual and rare presentation of cardiac myxoma with a double mitral lesion.

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Giant left atrial myxoma presenting as acute myocardial infarction

Cited by 8 publications

References 4 publications

Coronary Embolization from a Left Atrial Myxoma Containing Malignant Lymphoma Cells

Coronary Embolization from a Left Atrial Myxoma Containing Malignant Lymphoma Cells

Acute heart failure related to a large left atrial myxoma

Acute heart failure due to a giant left atrial myxoma: a case report

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