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Abstract
Cardiac myxomas are the most common benign tumors of the heart. They are most commonly found in the left atrium, followed by a right atrium and rarely in the left ventricle. Herein, we report a rare case of left ventricular myxoma in a patient who had twice undergone removal of left atrial myxoma. Complete removal of the tumor through aortotomy, without causing fragmentation led to the uneventful recovery of the patient.
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Affiliation(s)
- Ravi K Mahavar
- Department of Cardiac Anaesthesiology, Medanta-The Medicity, Gurugram, Haryana, India
| | - Dheeraj Arora
- Department of Cardiac Anaesthesiology, Medanta-The Medicity, Gurugram, Haryana, India
| | - Ajmer Singh
- Department of Cardiac Anaesthesiology, Medanta-The Medicity, Gurugram, Haryana, India
| | - Manisha Mishra
- Department of Cardiac Anaesthesiology, Medanta-The Medicity, Gurugram, Haryana, India
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2
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Ji X, Zhang X. Left atrial myxoma with left ventricular myxoma diagnosed by ultrasound examination: A case report. Medicine (Baltimore) 2021; 100:e26903. [PMID: 34397920 PMCID: PMC8360474 DOI: 10.1097/md.0000000000026903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/28/2021] [Accepted: 07/26/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Left ventricular (LV) myxoma is a rare type of benign cardiac tumor, which may result in unfavorable consequences due to embolism, arrhythmia, obstruction to the outflow tract, and other constitutional symptoms. LV myxoma can be easily misdiagnosed as LV thrombosis. Although some literatures have reported LV myxoma, the echocardiographic features of Left atrial (LA) myxoma with LV myxoma have rarely been reported till date. Here, we report case of LA myxoma with LV myxoma diagnosed by echocardiographic examination. PATIENT CONCERNS A 56-year-old male patient suffering from chest tightness and asthma for 6 months and progressive aggravation for 1 month was admitted to our hospital. DIAGNOSIS Echocardiographic imaging gave the suspicion of LA myxoma with LV myxoma, which was confirmed by pathology. INTERVENTIONS This patient was treated surgically. OUTCOMES The patient had no postoperative complications and is currently under regular follow-up. LESSONS Echocardiography can be an effective imaging method for the evaluation of LV myxoma. The combination of echocardiography and clinical symptoms may help to make an accurate diagnosis.
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Affiliation(s)
- Xiang Ji
- Department of Ultrasound, Yancheng Dafeng People's Hospital, Yancheng, Jiangsu, P.R. China
| | - Xia Zhang
- Department of Ultrasound, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, P.R. China
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3
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Ajaja MR, Cheikh A, Akpabie N, Elmire W, Mezalek AT, Hassani AE, Houssa MA. Left ventricular myxoma: case report. Pan Afr Med J 2020; 36:358. [PMID: 33224424 PMCID: PMC7664151 DOI: 10.11604/pamj.2020.36.358.24793] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/29/2020] [Indexed: 12/29/2022] Open
Abstract
Left ventricular (LV) myxomas are rare. We present a case of a LV myxoma arising from the interventricular septum in a 70-year-old asymptomatique man. General examination of the patient did not reveal any abnormality. Transthoracic echocardiography revealed a round pedunculated mass (size, 20mm x 13mm) at the interventricular septum with a broad pedicle. The mass was successfully removed and was pathologically confirmed to be a myxoma.
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Affiliation(s)
- Mohamed Rida Ajaja
- Department of Cardiac Surgery, Cheikh Zaid Hospital, Abulcasis University, Rabat, Morocco
| | - Amine Cheikh
- Department of Pharmacy, Cheikh Zaid Hospital, Abulcasis University, Rabat, Morocco
| | - Noëllie Akpabie
- Department of Cardiology, Cheikh Zaid Hospital, Abulcasis University, Rabat, Morocco
| | - Wafa Elmire
- Department of Cardiology, Cheikh Zaid Hospital, Abulcasis University, Rabat, Morocco
| | - Amale Tazi Mezalek
- Department of Cardiology, Cheikh Zaid Hospital, Abulcasis University, Rabat, Morocco
| | - Amine El Hassani
- Department of Pediatrics, Cheikh Zaid Hospital, Abulcasis University, Rabat, Morocco
| | - Mahdi Ait Houssa
- Department of Cardiac Surgery, Cheikh Zaid Hospital, Abulcasis University, Rabat, Morocco
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4
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Abstract
A cardiac myxoma may manifest as miscellaneous and uncharacteristic presentations. These unusual aspects of cardiac myxomas can be rare clinical presentations, special patient populations, unusual locations, and special pathology, which may lead to a delayed diagnosis, improper checkups, and subsequent untimely treatment, eventually resulting in unexpected poor prognosis. Therefore, the diagnosis of cardiac myxomas can be challenging because of these unusual aspects. In order to get a better understanding of a cardiac myxoma and to facilitate an early diagnosis and proper treatment, the unusual aspects of cardiac myxomas are described here.
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5
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A Large Left Ventricle Myxoma: Presenting with Epigastric Pain and Weight Loss. Case Rep Cardiol 2017; 2016:9018249. [PMID: 28090362 PMCID: PMC5206423 DOI: 10.1155/2016/9018249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 12/04/2016] [Indexed: 11/17/2022] Open
Abstract
Cardiac myxomas are the most common benign tumors found in the heart. They usually appear in the left atrium. Those originating from the left ventricle (LV) are rare. Although clinical presentation may vary, dyspnea and embolism are the most commonly reported symptoms. In the present case study, a 27-year-old woman with a large myxoma originating from the left ventricular free wall is studied. She had atypical complaints, mainly epigastric discomfort, nausea, vomiting, and anorexia. She was hospitalized for acute abdomen, but subsequent investigations revealed a large myxoma that fully filled the LV and severely compromised the flow of the aortic and mitral valves. After successful emergency tumor resection, all symptoms disappeared. The uncommon presentation caused by these tumors is discussed in this study.
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de Nijs MI, Vink A, Bergmann W, Szatmári V. Left ventricular cardiac myxoma and sudden death in a dog. Acta Vet Scand 2016; 58:41. [PMID: 27334273 PMCID: PMC4917938 DOI: 10.1186/s13028-016-0222-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 06/10/2016] [Indexed: 12/15/2022] Open
Abstract
Background Myxoma is a very rare benign cardiac tumor in dogs. This is the first description of a cardiac myxoma originating from the left ventricular outflow tract, presumably causing sudden death. Case presentation A previously healthy 12-year-old male West Highland white terrier was found dead during its 1-week stay in a kennel. The dog was known to have a cardiac murmur. On necropsy, a pedunculated neoplasia was found attached to the interventricular aspect of the left ventricular outflow tract, resulting in almost complete obstruction of the aorta. As this was the only abnormality identified, the tumor was considered as the cause of sudden death. Histopathologic findings were compatible with a myxoma. Conclusions Benign intraluminal tumors of the heart are very rare in dogs, but may have fatal consequences. Echocardiography could have revealed the cause of the cardiac murmur of this previously asymptomatic dog. Surgical removal could have been possible, as the tumor was pedunculated.
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Prevention of cerebral embolism progression by emergency surgery of the left atrial myxoma. Case Rep Med 2015; 2015:151802. [PMID: 25954312 PMCID: PMC4411460 DOI: 10.1155/2015/151802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/26/2015] [Accepted: 03/26/2015] [Indexed: 11/29/2022] Open
Abstract
A 21-year-old woman developed left hemiparesis during work and was hospitalized. Her National Institutes of Health Stroke Scale score was 4. Hyperintense areas in the left basal ganglia, corona radiata, and cortex of the temporal lobe were found by brain diffusion-weighted magnetic resonance imaging, indicating acute cerebral infarction. Echocardiography showed a giant mass of diameter 7 × 4 cm in the left atrium. Therefore, she was diagnosed with cerebral embolism due to a left atrial myxoma. Currently, thrombolytic therapy may continue to be effective because the embolic source may be composed of tumor tissue itself. In case of atrial myxoma, we considered that the use of tPA as emergency treatment in all patients with infarction by atrial myxoma may be questioned. Thus, cardiac tumor extraction was performed the next day after hospitalization without thrombolytic therapy. The excised myxoma measured 7 × 6 × 4 cm. The patient recovered and her neurological symptoms also improved. Furthermore, her National Institutes of Health Stroke Scale score improved to 0. Thirteen days after admission, the patient was discharged from our hospital. Cardiac myxoma is often associated with a high risk of embolic episodes, which emphasizes the need for prompt surgical excision as soon as the diagnosis is confirmed.
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Qin W, Wang L, Chen X, Liu P, Wang R. Left ventricular myxoma: a case report. J Biomed Res 2014; 28:506-8. [PMID: 25469121 PMCID: PMC4250964 DOI: 10.7555/jbr.28.20120124] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Revised: 12/24/2012] [Accepted: 02/07/2013] [Indexed: 11/16/2022] Open
Abstract
Cardiac myxoma, the most common primary heart tumor, is located mainly in the left atrium. We reported a rare case of left ventricular myxoma incidentally found on echocardiography in an asymptomatic 60-year-old male. The tumor was carefully resected without fragmentation. The patient had an uneventful recovery and was discharged home on the 4th postoperative day. Surgical resection of this type of cardiac myxoma is recommended due to the rarity of tumor location.
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Affiliation(s)
- Wei Qin
- Department of Cardiothoracic Surgery, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210006, China
| | - Liming Wang
- Department of Cardiothoracic Surgery, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210006, China
| | - Xin Chen
- Department of Cardiothoracic Surgery, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210006, China
| | - Peisheng Liu
- Department of Cardiothoracic Surgery, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210006, China
| | - Rui Wang
- Department of Cardiothoracic Surgery, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210006, China
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10
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Abstract
This report concerns a 69-year-old woman who presented with an asymptomatic myxoma in the left ventricle. The tumor was successfully excised. We provide a very brief review of 72 other published cases of surgically treated left ventricular myxoma.
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Affiliation(s)
- Cipriano Abad
- Departments of Cardiovascular Surgery (Dr. Abad), Cardiology (Drs. Delgado and Novoa), and Pathology (Dr. Alonso), Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria 35010, Spain
| | - José Novoa
- Departments of Cardiovascular Surgery (Dr. Abad), Cardiology (Drs. Delgado and Novoa), and Pathology (Dr. Alonso), Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria 35010, Spain
| | - Antonio Delgado
- Departments of Cardiovascular Surgery (Dr. Abad), Cardiology (Drs. Delgado and Novoa), and Pathology (Dr. Alonso), Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria 35010, Spain
| | - Ana Alonso
- Departments of Cardiovascular Surgery (Dr. Abad), Cardiology (Drs. Delgado and Novoa), and Pathology (Dr. Alonso), Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria 35010, Spain
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Abstract
Left ventricular (LV) myxoma is particularly rare in children and has not been reported in infants. A five-month-old baby presented with a myxoma arising from the anterior, lateral, and superior aspect of the LV, causing severe left ventricular outflow tract obstruction. The LV was accessed through the conal septum after opening the right ventricular outflow. The child had transient complete heart block in the postoperative period. There was no recurrence of tumor at the nine-month follow-up.
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Affiliation(s)
- Srinath N Reddy
- Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Cochin, Kerala, India
| | - Gs Sunil
- Department of Pediatric Cardiovascular Surgery, Amrita Institute of Medical Sciences, Cochin, Kerala, India
| | - Raman Krishna Kumar
- Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Cochin, Kerala, India
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Cetin M, Cakici M, Ercisli M, Polat M. Unusually located left ventricular outflow myxoma: a brief review of the literature. BMJ Case Rep 2013; 2013:bcr-2013-009610. [PMID: 23761565 DOI: 10.1136/bcr-2013-009610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Among all myxomas, left ventricular outflow tract (LVOT) myxomas are very rare. This article reports an LVOT myxoma in a 67-year-old woman presenting with palpitations and weight loss. Surgical excision of the LVOT myxoma was performed.
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Affiliation(s)
- Mustafa Cetin
- Department of Cardiology, Adiyaman University, School of Medicine, Adiyaman, Turkey
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13
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Simsek E, Durdu S, Hodo B, Yazicioglu L, Uysalel A. Left Ventricular Myxoma Producing Cardiac Failure. Heart Surg Forum 2013; 16:E57-9. [DOI: 10.1532/hsf98.20121063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
<p><b>Introduction:</b> Seventy-five percent of primary cardiac tumors are benign, and most are myxomas. Seventy-five percent of myxomas originate from the left atrium, and 2.5% arise from the left ventricle. Heart failure is a rare complication of myxoma.</p><p><b>Case:</b> A 54-year-old male patient with chronic obstructive pulmonary disease was admitted to the pulmonology department with a diagnosis of pneumonia and congestive heart failure during hospitalization. An echocardiography evaluation revealed a mobile mass (3.3 cm X 1.2 cm) in the left ventricle. The measured ejection fraction was 22%. Transthoracic and transesophageal echocardiography and magnetic resonance imaging examinations confirmed the presence of a myxoma in the left ventricle. The myxoma was a hanging mass with a stalk on the interventricular septum near the anterior mitral valve annulus. We visualized the gelatinous fragile mass on the septum; we then extracted the myxoma via a transaortic approach with the patient on cardiopulmonary bypass. The patient was discharged 10 days after surgery.</p><p><b>Discussion:</b> Myxoma is treated by early surgical resection because of the potential for serious complications. Left ventricular myxomas have been reported to lead to a silent heart failure. This case is important because of its location and the patient's resultant heart failure.</p>
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Abstract
Left ventricular myxoma are quite rare and have not been reported in children. We report a left ventricular myxoma arising from interventricular septum in a 12-year-old girl who presented with history of single episode of syncope while playing in school. General examination of the child did not reveal any abnormality except a grade II/VI systolic murmur in left parasternal area. Transthoracic echocardiography revealed a round pedunculated mass (18 × 30 mm) in left ventricle arising from middle of interventricular septum with a pedicle measuring 4 mm at its base. The tumour was projecting through aortic valve in systole. Syncope in this case was probably due to obstruction of left ventricular outflow tract by myxoma leading to a decrease in cardiac output. Complete excision of myxoma was done through transmitral approach.
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Affiliation(s)
- Prabhat Kumar
- Pediatric Cardiology, Military Hospital (Cardio Thoracic Centre), Golibar Maidan, Pune 411040, Maharashtra, India.
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Papillary fibroelastoma prolapsing into the left ventricular outflow tract: diagnosis using three-dimensional TEE. Herz 2010; 35:503-5. [PMID: 20857078 DOI: 10.1007/s00059-010-3380-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A 72-year-old woman was admitted to our hospital with exertional dyspnea and atrial tachycardia due to atypical atrial flutter. Comprehensive three-dimensional transesophageal echocardiography (3D-TEE) with offline reconstruction of the dataset (Siemens Foursight TEE, Erlangen, Germany) allowed visualization of the origin of the tumor and gave important additional information about the tumor: the tumor surface was floppy, it had the appearance of a "sea anemone", and it was attached to the endocardium of the head of the papillary muscle by a short stalk. The tumor was assessed to be 1.9 × 1.4 × 0.9 cm, and a prolapsing of the tumor into the left ventricular outflow tract during systole was demonstrated.A tumor size of 8 × 10 mm and an infiltration of the head of the anterior papillary muscle were found during surgery. The histopathological findings were typical for a papillary fibroelastoma (PFE) with involvement of the head of the papillary muscle.Our case indicates that a PFE might be difficult to distinguish from myxoma by echocardiography. Thus, the multimodal imaging approach and the three-dimensional visualization of the surface, the localization, and the attachment of the tumor to the head of a papillary muscle were very helpful for the identification of a fibroelastoma in this particular case.
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