Left Atrial Myxoma as a Rare Cause of Cardiogenic Shock in Octagerians: Report of a Case and Review of the Literature

Abstract

Introduction: Cardiogenic Shock (CS) is a state of end-organ hypo perfusion due to cardiac failure. It occurs in 5% to 8% of patients hospitalized with ST-elevation myocardial infarction (STEMI). Although myocardial infarction with left ventricle failure remains the most common cause of CS, it is crucial to exclude or / and identify rare pathologies that mimic this condition. Left atrial myxoma is the most common benign primary tumor of the heart, accounting for up to 50% of primary cardiac tumors. CS or even sudden cardiac death due to myxomas may result from either complete obstruction of the mitral valve orifice or MI resulting from coronary artery emboli. Case Presentation:We report a patient admitted to our department because of syncopal episode and altered mental status due to a large left atrium myxoma. The patient was treated surgically, the myxoma was removed and the systemic manifestations of organ malperfusion were reversed. Conclusion:Identifying myxoma as a rare pathology provoking CS in octageriansrequires a high index of suspicion and diagnosis can be sometimes elusive. Differential diagnosis of new onset cardiac dysrhythmias or even CS should include this infrequent noxiousness. Clinical icon varies from asymptomatic to causing severe morbidity and sudden death, with symptoms suggestive of different cardiac entities. Surgical removal remains simplex process offering curative treatment, an excellent prognosis and low recurrences rates.

Left Atrial Myxoma Presented with an Obstructive Shock, Right Ventricle Dysfunction and Pulmonary Hypertension

“…Transthoracic echocardiography is able to determine the size, location, and mobility with the sensitivity of 95%. 1,4,15 In this case, we used transthoracic echocardiography as the first imaging modality to diagnose myxoma and confirmed by the histopathological examination to confirm a cardiac myxoma (Figure 4B). When TTE has confirm the diagnosis of myxoma, surgery should be performed immediately due to the risk of embolism and sudden death.…”