Left atrial myxoma]

Left-atrial myxomas produce a broad array of clinical symptoms depending on their location, size, and morphology. The clinical presentation is characterized by obstruction of blood flow, systemic embolism, and unspecific systemic effects. Within 6 weeks, three patients presented in our clinic with left-atrial myxomas. Primary differential diagnoses were infective endocarditis, circulatory collapse, and transient ischemic attack of unknown origin. In all cases diagnosis was made with echocardiography (m-mode, 2D, TEE). In this review the etiology, epidemiology, and pathology are reported briefly. The variety of clinical symptoms with the corresponding differential diagnosis is presented systematically and discussed with our patients. Diagnostic, therapeutic, and prognostic aspects are summarized.     

Left atrial myxoma with aortic regurgitation.

A 59-year-old woman with a left atrial myxoma was shown to have moderate aortic regurgitation. At operation for removal of the myxoma it was found to be attached to the atrial septum close to the aortic root. It is suggested that the aortic regurgitation was caused by distortion of the aortic root caused by traction upon it from the myxoma as it moved downward into the left ventricle in diastole. Observations are made on the echocardiographic findings which helped in the diagnosis of the left atrial myxoma.     

Left atrial myxoma and systemic AL-amyloidosis.

A case of left atrial myxoma with systemic AL-amyloidosis is described. Localized myxomas have the peculiar property of giving rise to constitutional symptoms, indicating a systemic disease process. The coexistence of AL-amyloidosis and an atrial myxoma in the same patient makes it tempting to suggest that an immunological defect is involved in the development of both diseases.     

Left atrial myxoma in transplanted heart

Primary cardiac tumours are discovered in about 1 in 2000 necropsies. Cardiac myxomas make up half of all benign intracardiac tumours. Seventy five per cent are located in the left atrium. The first left atrial myxoma arising from the left atrium of a transplanted heart is reported.     

Left atrial myxoma: radioisotopic diagnosis

A case of left atrial Myxoma shown on an equilibrium radionuclide ventriculography is presented. The finding were consistent with the ecocardiographic patterns and the gross anatomy of the tumour. The analysis of various parameters obtained with gated radionuclide cardiac blood pool scan shows that the Fourier phase image is another method to detect and study this disease.     

Left hemiparesis from atrial myxoma emboli

Atrial Myxomas are benign primary tumors of the heart, arising mainly from the left atrium. Clinical signs and symptoms produced by atrial myxomas may be non-specific or result in mechanical obstruction of cardiac function, arrhythmias, and embolization. The authors present a case of a 60-year-old woman who developed total left hemiparesis resulting from left atrial myxoma embolization causing complete occlusion of the right middle cerebral artery.     

Left atrial myxoma: three-dimensional echocardiographic assessment

The patient was a 70-year-old female with antecedents of diabetes mellitus and hypertension, being followed up in the outpatient care clinic due to chronic anemia after corrective surgery for angiodysplasia of the proximal jejunum, in whom an image suggestive of left atrial myxoma was found on routine transthoracic echocardiography. Then multiplanar transesophageal echocardiography and 3-dimensional echocardiography were performed, showing the latter better anatomical details of the tumor. The patient underwent exeresis of the mass with anatomicopathological confirmation of the tumor. Three-dimensional echocardiography proved to be a technique that can provide additional contributions to the diagnostic investigation of structural heart diseases.     

Left atrial mass: thrombus mimicking myxoma

A 31-year-old woman underwent elective transthoracic echocardiography for paroxysmal atrial fibrillation, which showed a large left atrial mass. A two-dimensional echocardiogram showed a large left atrium mass. Subsequent transesophageal echocardiography showed a 3 cm x 3 cm circular mass with smooth contours. The differential diagnosis included myxoma versus thrombus, but because of morphology and mobility of the mass, it was difficult to differentiate one from the other. The patient had been on chronic coumadin therapy for paroxysmal atrial fibrillation. An operation was performed and the intracardiac mass resected. On pathologic examination the mass was diagnosed as an organized thrombus. A brief review of the literature has been presented to discuss the differential diagnosis of the mass in the left atrium.     

Left atrial myxoma infected with Streptococcus viridans

A case is described of Streptococcus viridans endocarditis involving a left atrial myxoma. The diagnosis was made by echocardiography and the infected tumour was successfully treated by surgical removal. A review of the published literature about left atrial myxomas underlines the importance of performing echocardiography in all patients with suspected endocarditis.     

Left atrial myxoma causing severe mitral valve occlusion

Myxoma is the most frequent cardiac tumor. We report a case of a young woman in whom a left atrial myxoma produced obstruction of the mitral valve and had to be removed during pregnancy.