A Rare Case of Left Atrial Myxoma With Coronary Fistula in a Patient With Dyspnea on Exertion

Left Atrial Myxoma Revealed by a Stroke in a Young Female Patient

“…These constitutional, general symptoms can err the diagnosis and lead to a delay in diagnosis or the revelation of the disease by a more serious manifestation such as cerebral embolic events or elsewhere in the vascular tree [9,[11][12]. These embolic incidents are found in 30 to 40% of cases and were the revealing mode in the first description of the left atrium myxoma described by Goldberg et al in a hemiparesis patient, similar to our patient [7,11,13]. These accidents are caused by the embolization of a myxomatous aneurysm, a friable tumor fragment, or an adherent thrombus, which explains why anticoagulation not only protects from these embolization incidents but also decreases the risk of dementia by progressive infarction or death by massive embolism in addition to neurological functional sequelae [5,7,14].…”

“…Transthoracic echocardiography (TTE) is the non-invasive imaging modality of choice, to be performed in patients with a stroke to eliminate the cardioembolic origin [7,[16][17][18]. In the case of a myxoma, TTE shows an inhomogeneous mass, pediculated, appended to the interatrial septum, and usually located in the left atrium [5,10,13,17]. This was the TTE finding of our young patient in whom a TTE was performed as part of the etiological assessment of her ischemic stroke.…”