Non-syndromic aortic valve myxoma in a teen, cause of angina symptoms

Abstract

Background Cardiac myxoma, a common benign primary tumor of the heart can be categorized into syndromic (Carney Complex) and non-syndromic(isolated). Carney Complex associated myxomas can be found in any region and system (cardiac, cutaneous, osseous, genitalia), and may manifest at a tender age. On the contrary, non-syndromic cardiac myxomas are usually confined to the chambers, and symptoms often present from 5th decade of life. Aortic valve myxoma is a very unusual occurrence, and presentation in a teen is extremely rare. Case report We share a case of aortic valve myxoma, uncovered using echocardiography in a 16-year-old male, admitted with complaints of exertional chest pain, dyspnoea and systolic murmur. Patient underwent uneventful surgery for tumor excision, and discharged 6-days post operation. Conclusion Given the high risk of developing cardiogenic stroke, infective endocarditis, degenerative effects on aortic valve leaflets and possible sudden death, like many other centers, we advocate for immediate liquidation of aortic myxoma regardless of age and symptoms.

Aortic valve myxoma—A systematic review of published cases

“…Most of the cardiac myxomas of the valvular origin occur in the fourth and seventh decade of life, but some rare cases of the aortic valve myxoma are reported at extreme ages as well as in teens and elderly. 3,4,8 Cardiac myxomas are primarily of two types: Carney complex and non-syndromic type. Most patients with the Carney complex are usually younger.…”

“…Exertional chest pain, dyspnoea, nausea, and vomiting, are some other symptoms. 2,3 Sometimes, the patient can be asymptomatic as well and it's just an incidental finding. 11,12 In our review of cases, 18.8% of cases were discovered incidentally.…”

“…Cerebrovascular events were found in one‐quarter of the cases under our study. Exertional chest pain, dyspnoea, nausea, and vomiting, are some other symptoms 2,3 . Sometimes, the patient can be asymptomatic as well and it's just an incidental finding 11,12 .…”

“…Cardiac myxoma is the most common primary cardiac tumour 1 . Cardiac myxomas mostly arise from the mitral valve (75%) and those originating from the aortic valve accounts for ~3% of the cardiac myxomas 2‐4 . Most of the cardiac tumours are a result of metastasis and they are 30 times more frequent than primary tumours‐like aortic valve myxoma 5 .…”

“…1 Cardiac myxomas mostly arise from the mitral valve (75%) and those originating from the aortic valve accounts for ~3% of the cardiac myxomas. [2][3][4] Most of the cardiac tumours are a result of metastasis and they are 30 times more frequent than primary tumours-like aortic valve myxoma. 5 Up to 20% of the myxomas are asymptomatic and 90% of them are located in the left atrium.…”