Hemoptysis in Pregnancy as the First Sign of Left Atrial Myxoma

Kanth, Pooja; Vu, T H; Daroowalla, Feroza

doi:10.1378/chest.1991271

Cited by 3 publications

(8 citation statements)

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“…The diagnostic techniques for the cardiac myxoma were described in 34 (66.7%) patients, by transthoracic echocardiography in 26 (70%) [ 2 , 8 - 13 , 17 , 20 , 21 , 24 , 27 - 29 , 33 - 35 , 38 , 40 , 42 , 43 , 45 , 47 , 48 , 50 ] , transthoracic and transesophageal echocardiography in 4 (13.3%) [ 15 , 27 , 30 , 32 ] , transesophageal echocardiography in 2 (6.7%) [ 36 , 41 ] , cardiac catheterization [ 14 ] and a battery of tests [ 46 ] in 1 (3.3%) patient.…”

Section: Resultsmentioning

confidence: 99%

“…The dimensions of the cardiac myxomas were available in 25 (49.0%) patients. One of them was described as "egg-sized" [ 46 ] and average dimension of the remaining 24 myxomas was 55.1±24.5 (range, 22-130; median, 55) mm ( n =24) [ 2 , 8 , 9 , 11 , 12 - 15 , 20 , 21 , 23 , 26 , 27 , 29 , 30 , 32 , 35 , 39 , 42 , 43 , 47 ] .…”

Section: Resultsmentioning

confidence: 99%

“…Concerning the remaining 49 patients, surgical operation was not performed in 2 (4.1%) patients but with anticoagulant and antibiotic therapy in one [ 36 ] and decline of treatment by another [ 41 ] . A surgical resection of cardiac myxoma was performed in 47 (95.9%) patients including a sole cardiac myxoma resection in 41 (87.2%) [ 2 , 8 - 21 , 23 - 27 , 29 , 31 - 39 , 43 - 46 , 48 - 50 ] , concurrent mitral valve repair [ 40 , 47 ] and staged mitral valve replacement [ 28 , 29 ] in 2 (4.3%), and staged mitral valve repair [ 30 ] and concurrent patent fossa ovalis closure [ 42 ] in 1 (2.1%) patient. Cardiac surgery was performed in the first, second and third trimester in 5 (13.9%), 14 (38.9%) and 17 (47.2%) patients ( χ 2 =9.8, P =0.008) at a mean of 25.2±9.4 (range, 9-41; median 27) weeks of gestational age ( n =36); while timing of cardiac surgery was not given in 15 (29.4%) patients.…”

Section: Resultsmentioning

confidence: 99%

“…A cardiac myxoma resection was delayed in 4 (7.8%) patients for a few [ 43 ] , 7 [ 21 ] , 15 [ 40 ] and 690 days [ 13 ] , respectively. The feto-neonatal fate was not mentioned in 13 (25.5%) cases [ 15 , 22 , 24 , 27 , 31 , 37 , 38 , 41 , 44 , 47 ] . Voluntary termination of pregnancy was done in 7 (13.7%) cases with 6 (85.7%) early-mid-termed [ 2 , 9 , 12 , 23 , 42 ] and 1 (14.3%) late pregnancy termination [ 50 ] with mean gestational age of 17.0±8.3 (range, 11-31; median, 14) weeks ( n =5).…”

Section: Resultsmentioning

confidence: 99%

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Cardiac myxoma in pregnancy: a comprehensive review

Yuan¹

2015

Revista Brasileira De Cirurgia Cardiovascular

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ObjectiveCardiac myxoma in pregnancy is rare and the clinical characteristics of this entity have been insufficiently elucidated. This article aims to describe the treatment options and the risk factors responsible for the maternal and feto-neonatal prognoses.MethodsA comprehensive search of the literature of cardiac myxoma in pregnancy was conducted and 44 articles with 51 patients were included in the present review.ResultsTransthoracic echocardiography was the most common diagnostic tool for the diagnosis of cardiac myxoma during pregnancy. Cardiac myxoma resection was performed in 95.9% (47/49); while no surgical resection was performed in 4.1% (2/49) patients (P=0.000). More patients had an isolated cardiac myxoma resection in comparison to those with a concurrent or staged additional cardiac operation [87.2% (41/47) vs. 12.8% (6/47), P=0.000]. A voluntary termination of the pregnancy was done in 7 (13.7%) cases. In the remaining 31 (60.8%) pregnant patients, cesarean section was the most common delivery mode representing 61.3% and vaginal delivery was more common accounting for 19.4%. Cardiac surgery was performed in the first, second and third trimester in 5 (13.9%), 14 (38.9%) and 17 (47.2%) patients, respectively. No patients died. In the delivery group, 20 (76.9%) neonates were event-free survivals, 4 (15.4%) were complicated and 2 (7.7%) died. Neonatal prognoses did not differ between the delivery modes, treatment options, timing of cardiac surgery and sequence of cardiac myxoma resection in relation to delivery.ConclusionThe diagnosis of cardiac myxoma in pregnancy is important. Surgical treatment of cardiac myxoma in the pregnant patients has brought about favorable maternal and feto-neonatal outcomes in the delivery group, which might be attributable to the shorter operation duration and non-emergency nature of the surgical intervention. Proper timing of cardiac surgery and improved cardiopulmonary bypass conditions may result in even better maternal and feto-neonatal survivals.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Cardiac myxoma in pregnancy: a comprehensive review

Yuan¹

2015

Revista Brasileira De Cirurgia Cardiovascular

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“…According to one retrospective study of 153 atrial myxoma patients between 1993 and 2017, only one presented with haemoptysis 9. In addition, haemoptysis is regarded as a more common presentation of right atrial myxoma, most likely related to tumour embolus to the lung 10. Unusual clinical presentations of myxoma include presentation with lower limb paresthesia due to arterial embolisation11 as well as presentation with abdominal pain due to bowel ischaemia 12.…”

Section: Discussionmentioning

confidence: 99%

Massive atrial myxoma presenting with unexplained haemoptysis

et al. 2022

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Cardiac myxomas are scarce and their clinical manifestations can often be misdiagnosed or confused with other medical conditions. However, early diagnosis and surgical resection can prevent devastating complications of myxomas.We herein describe a case of a huge left atrial myxoma of a female patient in her late 30s. What makes our case unique, apart from the massive size of the myxoma, is the unusual clinical presentation with incessant cough and haemoptysis for more than 6 months. The diagnosis was made by echocardiography and cardiac MR and successful surgical resection was performed with good long-term outcome.

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