One hundred patients aged 60 or older were studied clinically after excluding those with cardiac enlargement, definite valvular lesions or electrocardiographic (ECG) evidence of left ventricular hypertrophy. In 30 of the the 100 patients a significant systolic murmur was heard on auscultation. Phonocardiograms (PCGs), mitral echograms and pulse tracings were obtained in 28 of these 30 patients (2 had died meanwhile), and the ECGs and chest roentgenograms were reviewed. In 23 PCG patients there was an early or midsystolic murmur, best recorded at the base of the heart and often transmiteed to the apex. Mitral valve echograms and carotid and jugular pulse tracings were normal in all cases. Chest roentgenograms revealed aortic enlargement in 83 percent of the 23 patients. In the elderly with no evidence of organic heart disease, a basal systolic murmur is probably an aortic flow phenomenon caused by either moderate aortic dilatation or minimal fibrotic fusion of one or more commissures of the aortic valve.

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Resumen: Los mixomas son los tumores cardiacos primarios más frecuentes. Los síntomas varían y la presentación clínica suele ser progresiva y está relacionada con el tamaño y la localización del tumor. Nosotros describimos el caso de un paciente que presentó insuficiencia cardiaca severa refractaría al tratamiento médico como manifestación de un mixoma cardíaco gigante y que requirió cirugía de urgencia.