Right atrial myxoma. Report of a case and review of the literature

Sannerstedt, Rune; Varnauskas, E; Paulin, Sven; Linder, Erland; Ljunggren, H; Werkö, Lars

doi:10.1016/0002-8703(62)90336-8

Cited by 40 publications

(8 citation statements)

References 12 publications

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“…Nevertheless, the short history, the absence of mitral valve disease, the absence of a right ventricular heave, the presence of normal sinus rhythm (Morrissey et al, 1963), the high blood sedimentation rate, and hypergammaglobulinaemia, all supported the clinical diagnosis of right atrial myxoma. It is interesting that the high peaked P wave seen in the electro-cardiogram in our patient and described by others in right atrial myxoma (Sannerstedt et al, 1962), disappeared immediately after the removal of the tumour while the patient was still on the operating table.…”

Section: Discussionsupporting

confidence: 78%

“…On deep inspiration there was a significant deepening of the y descent from 12 mmHg to 2 mmHg, indicating a changing, dynanic obstruction of the right ventricle inflow tract. These haemodynamic features can be helpful in the diagnosis ofprolapsing right atrial myxoma.Myxomata of the atria are uncommon, especially in the right atrium (Sannerstedt et al, 1962;Morrissey et al, 1963). Recently, Sung et al (1975) differentiated between two types of left atrial myxoma: type I, in which the tumour prolapses during diastole into the left ventricle, and type II, which is non-prolapsing.…”

mentioning

confidence: 99%

“…Myxomata of the atria are uncommon, especially in the right atrium (Sannerstedt et al, 1962;Morrissey et al, 1963). Recently, Sung et al (1975) differentiated between two types of left atrial myxoma: type I, in which the tumour prolapses during diastole into the left ventricle, and type II, which is non-prolapsing.…”

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confidence: 99%

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Prolapsing right atrial myxoma: clinical and heamodynamic considerations.

Roguin¹,

Amikam²,

Riss³

1977

Heart

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A 22-year-old woman with a right atrial myxoma prolapsing to the right ventricle is described. The haemodynanmc findings were similar to those of cases of prolapsing myxoma of the left atrium; a notching on the ascending limb of the right ventricular pressure curve, and an initial negative, irregular deflection on the pulmonary artery pressure curve with a pronounced rise in the mean right atrial pressure (18 mmHg) were found. On deep inspiration there was a significant deepening of the y descent from 12 mmHg to 2 mmHg, indicating a changing, dynanic obstruction of the right ventricle inflow tract. These haemodynamic features can be helpful in the diagnosis ofprolapsing right atrial myxoma.Myxomata of the atria are uncommon, especially in the right atrium (Sannerstedt et al., 1962;Morrissey et al., 1963). Recently, Sung et al. (1975) differentiated between two types of left atrial myxoma: type I, in which the tumour prolapses during diastole into the left ventricle, and type II, which is non-prolapsing. Sung described a notch in the upstroke of the left ventricular pressure curve and a rapid y descent in the pulmonary arterial wedge pressure curve as characteristic of the prolapsing type.The purpose of this report is to present a case of a right atrial myxoma, prolapsing during diastole into the right ventricle, producing haemodynamic features similar to those described by Sung for the prolapsing left atrial myxoma. Case reportA 22-year-old single woman of Arabian origin had been completely well until 6 months before her admission, when she began complaining of palpitation, frequent cough, and haemoptysis; one month before admission her complaints became worse with pain in the right posterior thorax, frequent nausea and vomiting, and a loss of 7 kg in weight. On admission she had a temperature of 37 9°C; there was no cyanosis, clubbing, or dyspnoea; her blood pressure was 120/80 mmHg, pulse rate 110/ min, with regular rhythm. There was pronounced jugular venous engorgement with prominent a and v waves and a negative Kussmaul sign. Auscultation of the lungs revealed poor air entry into the right lung base and a pleural friction rub at the left base. The apex beat was palpated in the left fifth interspace in the midclavicular line; no right ventricular heave was noted. A diastolic thrill at the lower left sternal border was palpable; the first heart sound was prolonged and accentuated. The second sound was normal; a grade 4/6 mid-diastolic presystolic murmur extending into the first sound and early systole was heard at the lower left sternal border. The character of the murmur was similar to a pericardial friction rub; the intensity of the murmur was unaffected by the position of the patient but increased slightly on deep inspiration. The liver was palpable 5 cm below the costal margin and tender; the spleen was not palpable. There was mild pitting oedema in both legs.The electrocardiogram showed sinus rhythm with a rate of I10/min, tall P waves in leads II, III, and aVF. The QRS axis was + 1200, and there were n...

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Section: Discussionsupporting

confidence: 78%

mentioning

confidence: 99%

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Prolapsing right atrial myxoma: clinical and heamodynamic considerations.

Roguin¹,

Amikam²,

Riss³

1977

Heart

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“…Surgical removal was successful in 10 of these 18 cases. Since that time there have been further reports of the successful diagnosis and surgical removal of right atrial myxomata (Barlow et al, 1962;Catt et a!., 1962;Sannerstedt et al, 1962;Brandfonbrener et al, 1963;Bross, 1965;Currey et al, 1967;Sanyal et al, 1967). Some degree of polycythaemia has been reported in five cases (Macoun, 1949;Bahnson and Newman, 1953;Alessandri et al, 1960;Levinson and Kincaid, 1961;Siggillino et al, 1963) and slight polycythaemia was also a feature of our case.…”

Section: Right Atrial Myxoma With Right-to-leftsupporting

confidence: 54%

Right atrial myxoma with right-to-left interatrial shunt and polycythaemia.

Miller¹,

Paneth²,

Gibson³

1968

BMJ

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“…It will be noted that most of these cases were reported after 1960. An earlier review was made by Sannerstedt et al (1962):…”

Section: Radiological Findingsmentioning

confidence: 99%

Calcified right atrial mass: Report of a case and discussion of the differential diagnosis

Fleming

Stovin

1972

Thorax

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This is the report of a case of a grossly calcified right atrial mass in a woman of 40 who also suffered from systemic hypertension, pyelonephritis, and hepatic cirrhosis. The differential diagnosis, surgical treatment, and necropsy findings are described along with a review of the literature.Myxoma is the commonest intracardiac tumour and it is well known to present in bizarre ways, particularly when on the right side of the heart. The frequency of serious co-existent disease is striking and adds to the difficulty of diagnosis. Calcification of the tumour is uncommon, though probably more frequent in right than in left heart tumours; massive calcification is rare. Diagnosis can be followed by surgery with very satisfactory results.The purpose of this paper is to present the case of an enormous, grossly calcified mass in the right atrium which extended down into the inferior vena cava and was associated with large calcified deposits in the main pulmonary artery and in the lungs. Although no recognizable myxoma tissue remained there is strong evidence that this was, in fact, a 'burnt-out' myxoma. The patient also had chronic pyelonephritis and hepatic cirrhosis.The difficulty of diagnosis is discussed and the literature on calcified atrial myxomata is reviewed. CASE HISTORYMrs. E. L. was aged 40 years when first seen in 1968.In 1951 she had suffered from severe pre-eclamptic toxaemia leading to an abortion at five months. Her blood pressure was 190/120 mmHg and on that occasion pus cells, red blood cells, and granular casts were found in the urine. She was subsequently admitted for inevitable abortions in May and again in August 1955. These were at approximately three and two months' gestation respectively.In June 1968 she was referred for treatment of menorrhagia of six months' duration. She was found to have a blood pressure of 220/160 mmHg and heavy albuminuria. The uterus was bulky and before a dilatation and curettage she was referred for a medical opinion to Dr. K. D. Allanby who made the following observations. She was breathless on climbing stairs. She slept on two pillows and there had been gross ankle oedema for six months. A rash and periorbital oedema had appeared about one week previously and were attributed to strawberries. The venous pressure was above the angle of the jaw, oedema of the legs was well marked, and there was hepatomegaly. A coarse rub, probably of pericardial origin, was heard.A diagnosis of cellulitis of the legs was made, and she was admitted to Peterborough Memorial Hospital immediately. A haemolytic streptococcus was isolated from the throat and she was therefore treated with penicillin. She was also treated with chlorothiazide and methyldopa, with some improvement. However, at the end of one month she was still in congestive cardiac failure and grossly overweight. The treatment of her heart failure was intensified but the result was disappointing. The 'pericardial rub' varied in intensity but never disappeared. On occasions she complained of a feeling of tightness in the chest. ...

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Right atrial myxoma. Report of a case and review of the literature

Cited by 40 publications

References 12 publications

Prolapsing right atrial myxoma: clinical and heamodynamic considerations.

Prolapsing right atrial myxoma: clinical and heamodynamic considerations.

Right atrial myxoma with right-to-left interatrial shunt and polycythaemia.

Calcified right atrial mass: Report of a case and discussion of the differential diagnosis

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