Right Atrioventricular Myxoma Presenting with Recurrent Syncopal Attacks

Abstract

Patient: Female, 38-year-old Final Diagnosis: Myxoma Symptoms: Dyspena • syncope Medication: — Clinical Procedure: Surgery Specialty: Cardiac Surgery • Cardiology Objective: Rare disease Background: Myxomas are rare benign tumors of the heart. These tumors are commonly located in the left atrium, but rarely can affect the right side of the heart. Although it is a relatively rare tumor, it is the most common primary cardiac tumor, accounting for 75-80% of them. Secondary or metastatic cardiac tumors are much more common than primary tumors, accounting for more than 95% of cardiac tumors. Case Report: A 38-year-old woman presented with shortness of breath and syncope. Upon investigation, she was found to have a right atrioventricular myxoma. It was associated with tricuspid regurgitation, right-sided heart failure, and pulmonary hypertension. The syncopal attacks and shortness of breath resolved completely after tumor resection. Tricuspid regurgitation (grade 1) and mild pulmonary hypertension (right ventricular systolic pressure 35 mmHg) remained as sequelae of delayed presentation. These may be due to recurrent embolization of tumor fragments to segments of the pulmonary artery. Conclusions: Cardiac myxomas should be considered in patients presenting with unexplained shortness of breath and syncope. Early diagnosis and tumor resection may prevent serious complications such as pulmonary hypertension and right-sided heart failure.

Considerations and anesthetic management of a patient with giant right atrial myxoma: A case report and literature review

“…Constitutional symptoms may include fever, weight loss, and anemia mimicking infective bacterial endocarditis or systemic vasculitis. [ 6 ] Although 2-dimensional TTE has its limitations, a central venous catheter (internal jugular vein) was inserted under visualization with TTE to prevent embolization of tumor fragments that originate from contact between a catheter and the tumor into the pulmonary vessels. [ 7 ] In this patient, tumor embolization seems unlikely in light of a normal TTE or TEE scan and ultrasound-guided internal jugular vein placement.…”

Acute Coronary Syndrome or Right Atrial Cardiac Myxoma? An Atypical Presentation

“…Upon investigation, the patient had evidence of right-sided heart failure with associated tricuspid regurgitation and pulmonary hypertension. A mass was located which originated below the fossa ovalis affecting the tricuspid valve causing a right ventricular outflow obstruction [ 5 ]. Both these cases in our literature review portrayed a right atrial myxoma which caused valvular dysfunction, thus leading to a right ventricular outflow tract obstruction resulting in their ultimate presentation.…”

A comparison of total thoracoscopic versus robotic approach for cardiac myxoma resection: a single-center retrospective study

“…Cardiac myxoma is the most common type of primary cardiac tumor [1], which accounts for about 75-80% of all the primary neoplasms in the heart [2]. The prevalence of the cardiac myxoma is estimated to be 0.5 per million per year [3].…”