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A patient with a 456 Gram right atrial myxoma is described. Associated rheumatic mitral valvular heart disease obscured the presence of the tumor and only with presentation of bradyarrhythmias leading to pacemaker implantation was the diagnosis suspected. Successful surgical removal of the tumor and correction of the intracardiac valvular dysfunction were performed. The role of echocardiography in the early detection of these tumors is reinforced.

A young woman with mitral valve prolapse and ventricular tachycardia refractory to numerous antiarrhythmics, received a trial of aprindine. During the course of treatment she developed a severe psychotic reaction that resolved after the drug was stopped. Her psychosis was unassociated with the other dose-related neurological side effects of aprindine, and occurred at borderline therapeutic levels of the drug.