Left Atrial Myxoma Embolization Presenting as Acute Limb Ischemia: An Unusual Presentation

Abstract

Cardiac myxomas are rare with reported incidences of less than 0.03%. Cardiac myxomas are most commonly observed in the left atrium. Their clinical manifestations vary and most are non-specific to the diagnosis. The most common extra-cardiac manifestations are thrombo-embolic infarcts from tumor embolization. A previously healthy 55-year-old man presented with findings suggestive of acute arterial limb ischemia. Following surgical treatment of his acute presentation, a left atrial mass was found on echocardiography suggesting that the embolization was secondary to a cardiac myxoma. The patient was discharged without complication. Embolic myxoma should be included in the differential in younger, previously healthy patients presenting with acute arterial limb ischemia without obvious cause. Our patient’s dramatic presentation with a single acute event, however, prompted immediate treatment and resulted in a functional recovery with minimal complications.

Clinical Characteristics of Acute Lower Extremity Ischemia Due to Left Atrial Myxoma: A Rare Case Report with Review of Literature

“…A literature search of the PubMed database returned 58 cases of limb ischemia due to LAM over the past 40 years, as summarized in Table 1 (Ref. [2,).…”

“…Primary cardiac myxomas (CMs) are rare, with a reported prevalence of 0.03% in the general population. CMs account for approximately 50% of all cardiac tumors, of which 75-85% are located in the left atrium and 15% in the right atrium [1,2]. A few CMs can occur in the right ventricle or left ventricle and may even be biatrial.…”

“…CMs have a female preponderance, with a female-to-male ratio of approximately 2-3:1, and can occur at all ages, although they mainly occur in middle-aged patients between the 3rd and 6th decades of life. Furthermore, 10-50% of patients with CMs are asymptomatic [1][2][3]. The clinical manifestations of CMs are characterized by intracardiac obstruction, systemic embolism, and constitutional symptoms.…”