A cryptogenic pulmonary embolism: Left atrial myxoma occluding an atrial septal defect

Abstract

cute pulmonary embolism represents a severe condition associated with significant morbidity and mortality. 1 The main source of pulmonary embolism is represented by deep venous thrombosis. Less frequent causes are right-sided heart chamber clots, neoplastic emboli into the systemic veins, or the association of left atrial (LA) thrombi and atrial septal defects (ASDs). We describe a unique case of acute pulmonary embolism related to the contemporary presence of LA myxoma and ASD, with the mass behaving as an ASD occluder.

Atrial myxoma causing cerebral embolic ischemic stroke as the first presentation in an apparently asymptomatic young male with birth asphyxial injury: a case report

“…2 Approximately one-half of the cases of myxomas are pedunculated tumors, and these are irregular and more likely to result in emboli because of the mobility of this type of tumor. 3 Sixty to 75% of cardiac myxomas develop in the left atrium, most of which are from the atrial septum near the fossa ovalis. Most other myxomas develop in the right atrium.…”

“…7 This embolization includes pulmonary embolism, myocardial infarction, mesenteric infarction, retinal artery occlusion, spinal cord ischemia, and stroke. [2][3][4][5][6][7] Ischemic infarction of the brain is responsible for the majority of cases of systemic embolization. The MCA is frequently affected by this type of infarction because of the MCA's dominant blood flow.…”

Recurrent Embolization of a Left Atrial Myxoma Resulting in Acute Cerebral Ischemia

“…Cerebral arteries are affected up to 50 % of cases [2,3]. Pulmonary arteries, coronary arteries, retinal arteries, kidneys, spleen, intestine, and lower extremities are the other sites of embolization [4,5]. Emboli are most often multible and myxomatous, but may also arise from thrombus adherent to the tumor [6].…”

Hemorrhagic Atrial Myxoma Causing a Cardioembolic Stroke: A Case Report

“…Tumor size varies between 1-15cm with a mean tumor diameter of 2.7±1.3cm. Histologically, myxomas originate from mesenchymal cells of the septal endocardium, are gelatinous with a smooth or lobulated surface, usually white, yellow or brown in colorand can be villous, papillary, sessile or pedunculated [2,4,7]. The pedunculated type accounts for approximately half of the cases and are the most likely to cause emboli due to their mobility [7].…”

“…Histologically, myxomas originate from mesenchymal cells of the septal endocardium, are gelatinous with a smooth or lobulated surface, usually white, yellow or brown in colorand can be villous, papillary, sessile or pedunculated [2,4,7]. The pedunculated type accounts for approximately half of the cases and are the most likely to cause emboli due to their mobility [7]. Although embolization can occur is multiple different organ systems, cerebral infarctions are the most common and the MCA is the predominant area affected [4,8].…”