Large Left Atrial Myxoma Causing Mitral Valve Obstruction: A Rare Cause of Syncope

A Rare Case of Massive Left Atrial Myxoma Presenting as Syncope

We report a rare case of a large left atrial myxoma that manifested as syncope in a patient who presented to the hospital following a syncopal episode. Our patient had a history of hypertension and anemia with reported two months of dyspnea on exertion. He was found to have a large left atrial myxoma. Atrial myxomas are the most common benign primary cardiac tumors. Patients may be asymptomatic or experience shortness of breath, palpitations, syncope, or sudden death. Cases of syncope caused by left atrial myxoma have been rarely documented. Our case report adds to the growing literature documenting this phenomenon. Larger observational studies are needed to properly define the incidence of left atrial myxoma causing syncope.

Giant right ventricular myxoma presenting as right heart failure with systemic congestion: a rare case report

Background

Myxoma is an uncommon disease and its symptoms vary greatly depending on size, location and mobility. Right-sided myxoma, especially right ventricular myxoma, is much rarer, and the symptoms are alien and uncharacteristic. The lack of understandings poses challenges to prompt diagnosis and timely treatment.

Case presentation

A 44-year-old female patient was diagnosed with giant right ventricular tumor. Right heart failure and systemic congestion caused by right ventricular outflow tract obstruction were observed on this case. Surgery was performed to excise the mass which was measured at 9.5 * 5.0 cm and confirmed as myxoma pathologically.

Conclusions

Right-side myxoma is easy to be unnoticed due to its low incident rate and atypical symptoms. Delay in surgical intervention might cause unrecoverable complications. More comprehensive understanding of the symptoms is expected to help improving the diagnose and treat of right-sided myxoma.

Giant Left Atrial Myxoma Masquerading as Cough-Syncope Syndrome

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.

Two-dimensional Speckle Tracking Echocardiography and Three-dimensional Echocardiography Characterization of Left Atrial Giant Myxoma

Myxomas are the most common cancerous nonneoplasms among the rare heart's tumors. Usually, they are located in the left atrium (LA). They are more frequent in women than in men and ranged in age from 30 to 50 years. Rarely, myxoma is completely asymptomatic and in that case represents a fortuitous discovery. However, usually, it is characterized by several symptoms as fatigue, dyspnea, chest pain, dizziness, cough, and sometimes, by sudden death. We refer on a case of LA myxoma found in a woman without symptoms but having a systolic precordial murmur. Two-dimensional echocardiography (2-DE) shown an unknown giant LA myxoma, almost completely occupying the atrial cavity. 2-D left atrial longitudinal speckle tracking echocardiography first allowed to note the changes in the percentage of "reservoir," "conduit," and "booster pump" phases of the left atrial function respect to normal subjects, revealing LA dysfunction. Three-dimensional echocardiography (3-DE) shown left atrial mass and its attachment to the atrial septum better than 2-DE. Furthermore, 3-DE allowed to define the shape of LA myxoma and its 3-D, irregular contour.