Mixoma atrial gigante simulando estenose mitral grave em paciente jovem

Abstract

KeywordsMyxoma; giant cell tumors; mitral valve stenosis; adolescent.The echocardiogram of a twenty-year-old man, previously healthy, suffering from paroxysmal nocturnal dyspnea and fatigue after moderate exertion that intensified over a period of about ten days, showed the left atrium myxoma working as severe mitral stenosis. A physical examination revealed blood pressure of 110X70 mmHg, regular two-beat heart rhythm, systolic murmur in mitral area and without any changes in the rest of the physical examination. The electrocardiogram revealed a right bundle branch block. The echocardiogram showed a large mass that occupied almost the entire left atrium (4.3 x 8.0 cm in size). This mass was stuck to the posterior superior wall of the left atrium. The diameter of the left atrium was 5.6 cm and the estimated volume was 98 cm³. Part of the mass protruded through the mitral valve to the left ventricle during the atrial systole (the estimated valve area was 1 cm²), causing a restriction of the mitral flow that was compatible with severe stenosis (severe mitral stenosis). Then, surgery was indicated for removal of the tumor. Giant Atrial Myxoma Mimicking Severe Mitral Stenosis in Young PatientIn preoperative examinations, the only change found was microcytic and hypochromic anemia. Then, the exeresis of the tumor was performed with resection of the fossa ovalis and atrioseptoplasty was performed with the use of bovine pericardium. The histopathology of the specimen confirmed the diagnosis of left atrial myxoma. There were no complications in the postoperative period and the patient was discharged five days after surgery.

An Exceptional Cardiac Myxoma Case Defying Convention

“…Additionally, threedimensional reconstruction allows for a detailed assessment of the mass, evaluation of mitral valve compromise, and a thorough examination of left atrial morphology. This aids in ruling out alternative diagnoses [3,4].…”