Project description:Abstract Cardiac myxomas are the most common primary cardiac tumors in adults, with the left atrium being the most frequently affected. Echocardiography is the diagnostic modality of choice. The most effective treatment for cardiac myxomas is surgical excision. We present a clinical video of a large left atrial myxoma causing mitral valve obstruction, highlighting the importance of echocardiography as a diagnostic modality to facilitate referral to a tertiary center.
Project description:Key clinical messageSyncopal patients should be evaluated for cardiac causes, including myxoma, as highlighted in this case. Transthoracic echocardiography and coronary angiography are valuable diagnostic tools. Interventional cardiology plays a crucial role in the successful treatment of myxoma.AbstractThis case video describes the presentation and successful treatment of a 58-year-old woman who experienced recurrent episodes of syncope. After ruling out other health concerns, a pulmonary embolism was suspected and further investigations revealed a mass in the left atrium causing significant obstruction of the mitral valve. The mass, identified as a neovascularized myxoma, was successfully resected, emphasizing the significance of considering myxoma as a potential cause of syncope and highlighting the role of interventional cardiology in its management.
Project description:Rheumatic mitral stenosis associated with left atrial myxoma has been reported previously. We reported an admitted rare case of rheumatic mitral regurgitation with left atrial myxoma. The discrimination between left atrial myxoma and thrombi presents a diagnostic challenge in the presence of rheumatic mitral valve disease.
Project description:A 72-year-old male with atrial fibrillation (AF) underwent mitral valve (MV) repair and concomitant procedures. He was discharged with therapeutic Warfarin dosing but was readmitted 3 weeks later with a right caudate nucleus infarct and subtherapeutic anticoagulation. Echocardiography showed a giant left atrial (LA) thrombus. Low-molecular-weight heparin was promptly initiated. Unfortunately, the patient suffered an intracranial hemorrhage (ICH) 2 days later. He declined surgical thrombectomy and was managed conservatively, remaining stable without neurological deficits. Serial brain imaging showed interval stability, allowing Warfarin to be resumed. Follow-up echocardiography demonstrated partial and complete resolution of the thrombus at 1 and 3 months, respectively.
Project description:Left atrial myxomas are the most common type of benign primary cardiac tumor. Patients can present with generalized symptoms, such as fatigue, symptoms from obstruction of the myxoma, or even embolization of the myxoma causing distal thrombosis. We describe a case with several-month duration of syncopal episodes that occurred after coughing and with exertion. Computed tomography of the chest showed a 6.1 cm by 4.5 cm mass in the left atrium, later evaluated with an echocardiogram. Cardiothoracic surgery removed the mass, and it was determined to be an atrial myxoma. It is important for an internist to be able to diagnose an atrial myxoma because of the risks associated with embolization and even sudden death as myxoma can block blood supply from atrium to ventricle.
Project description:Unguarded mitral valve orifice is a rare disease with only 7 described cases in the literature. We describe the first known case of unguarded mitral valve orifice with normal segmental cardiac anatomy, severe left ventricular dilatation and dysfunction, aortic atresia, and atrial flutter. (Level of Difficulty: Advanced.).
Project description:Myxomas are the most common primary cardiac tumors. The cardiac myxomas are mostly diagnosed within the atria, and only a few such tumors are reported to have arisen from atrioventricular valves or pulmonary vessels. The authors here present a case of 59-year-old Chinese woman who was hospitalized for exacerbating symptoms of tricuspid stenosis and right heart failure. Echocardiography revealed a giant right atrial myxoma arising from an extremely rare site, the anterior wall of the superior vena cava. With the aid of transesophageal echocardiography, the surgical resection was performed successfully with the patient achieving complete recovery.