A rare myxoma-like right atrial thrombus causing syncope

Abstract

Rationale:Syncope is a complicated clinical condition involving various diseases. Syncope due to myxoma-like right atrial thrombus is rarely seen in patient without structural heart disease.Patient concerns:A 61-year-old ambulant old male visited our emergency department for sudden syncope.Diagnoses:After the exclusion of neurological and coronary diseases, a right atrial block mass with a stalk connected to the atrial septum was accidentally found by echocardiography. Pulmonary embolism was subsequently revealed by computed tomographic pulmonary angiography. Atrial myxoma was initially suspected and surgical removal was conducted. Surprisingly, histological examination showed that the pedicled block mass was actually thrombus.Interventions:The myxoma-like right atrial thrombus and the emboli in the bilateral pulmonary trunks were resected. This patient received anticoagulant treatment with warfarin for 6 months additionally.Outcomes:The patient was successfully discharged and being continually followed.Conclusion:This patient had a past medical history of right femoral neck fracture, which might be responsible for the formation of the myxoma-like right atrial thrombus. We should always consider echocardiography examination in syncope patient at risk of thrombus formation.

Right Atrial Thrombus Presenting as Platypnea-Orthodeoxia Secondary to Reverse Lutembacher Syndrome: A Case Report

“…The exact prevalence of RAT is unknown but it was seen in 7% of 23,796 autopsies conducted in one review [ 13 ]. Syncopal episodes due to RAT have also been reported [ 14 ]. The presence of a foreign body such as a central venous catheter can lead to the development of RAT and subsequent PE [ 15 ].…”

Case report: A rare case of recurrent right atrial mass dramatically disappeared after anticoagulation

“…After anticoagulation treatment, the right atrial mass was smaller than before, which verified the diagnosis of right atrial thrombosis. A total of 5 cases of myxoma-like right atrial thrombosis in the past 10 years from 2011 to 2021 were screened out through PubMed, including 4 elderly patients and 1 young patient, showing different symptoms such as palpitations, dyspnea and syncope (7)(8)(9)(10)(11). All patients had thromboembolic causes of cardiac thrombosis, including cardiac structural abnormalities, catheter-related thrombosis, pacemaker implantation, and longterm bed rest history.…”