Primary cardiac tumors, such as myxomas, are rare. About 75% of myxomas occur in the left atrium of the heart. Myxomas can have a broad clinical spectrum. The clinical presentation varies from asymptomatic to sudden cardiac death. Sometimes, a diagnosis is difficult. Cardiac myxoma can cause hemodynamic disturbances in the setting of pneumonia and hypercoagulable state in patients with Coronavirus disease 2019(COVID-19) and make treatment decisions difficult. We present a case of unusually huge left atrial mass discovered incidentally in a patient with COVID-19. Upon workup, an echocardiogram revealed an incidental 7 × 5 cm left atrial myxoma. Preoperatively, the patient was monitored closely in the ICU. After stabilization in the ICU, the patient was taken to surgery and the tumor was successfully removed. Pathohistological results after surgical removal of the tumor confirmed the diagnosis of cardiac myxoma. We consider our case extremely rare due to the asymptomatic course despite the large size of the tumor.

A 38-year-old woman was discovered to have a systolic murmur for an unrelated complaint. Transesophageal echocardiography showed no atrial or ventricular septal defects, but multiple large collateral vessels in interventricular septum. The origin of left coronary artery was not seen at the expected site on the aortic root. The 64-multislice computed tomography confirmed the diagnosis of an anomalous origin of the left coronary artery from the pulmonary artery. Left coronary artery was revascularized with a saphenous vein graft with an uneventful recovery.Keywords Anomalous origin of the left coronary artery from the pulmonary artery Á Multislice Á Computed axial tomography During physical examination, a 38-year-old woman was found to have an asymptomatic systolic murmur. The electrocardiogram was normal, and the chest radiograph showed mild cardiomegaly. Transthoracic echocardiography showed a moderately decreased systolic function (ejection fraction = 35%), no mitral regurgitation, and multiple muscular ventricular septal defects (VSDs), i.e., a possible ''Swiss cheese'' VSD. In contrast, the transesophageal echocardiogram showed no atrial or ventricular septal defects; instead, there were multiple large collateral vessels in the interventricular septum. Because the origin of the left coronary artery (LCA) was not visualized, and to better clarify the anatomy, a contrast-enhanced 64-multislice computed tomogragraphy (MSCT) was performed. The tomogram showed a dilated and tortuous right coronary artery arising from the right sinus of Valsalva and giving off extensive collateral vessels coursing over the right ventricular wall, the interventricular septum, and the apex to the LCA that originated from the proximal main pulmonary artery (Fig. 1a-c). Therefore, the diagnosis of anomalous origin of the LCA from the pulmonary artery (ALCAPA) was confirmed. Technically, transfer of the LCA from the PA was not feasible; thus, the LCA coronary origin was oversewn and a saphenous vein graft from the aorta to the LCA was performed. The patient's postoperative course was uneventful.

Among benign cardiac tumors, cardiac blood cysts are rare. These congenital lesions may develop in any heart’s cavities and they are not often seen in adults. The present article is a report of a right atrium blood cyst and calcified kernel in an adult case.

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