Atrial myxoma surgery and P‐wave remodeling

Herrera, Cristian; Bruña, Vanesa; Barrio, José María; Cuerpo, Gregorio; Fernández‐Avilés, Francisco; Luna, Antonio; Martínez‐Sellés, Manuel

doi:10.1111/pace.14573

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…Approximately 95% of cardiac myxomas occur in individuals of a wide age range. However, they occur more frequently among women in the fth or sixth decade of life [2]. We reported a 59-year-old Chinese woman with a giant left atrial myxoma misdiagnosed as schizophrenia for eight years, an incident that is quite rare.…”

Section: Introductionmentioning

confidence: 88%

Giant cardiac myxoma misdiagnosed as schizophrenia: a case report

Wang

2022

Preprint

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Background Myxoma is the most common cardiac tumor and usually presents in the left atrium. Patients typically present with tightness of the chest, fatigue and lassitude. There are also cases of misdiagnosis and missed diagnosis. Improvements tend to occur with early diagnosis, and with the help of high-resolution imaging technology, such as transthoracic echocardiography (TTE), transesophageal echocardiography (TEE) and computed tomography (CT). Case presentation: A 59-year-old Chinese woman complained of tightness in her chest, fatigue and lassitude for eight years. She had been misdiagnosed with schizophrenia by the local rural hospital. CT confirmed a giant mass in the left atrium, and TTE revealed left atrial enlargement with an occupying lesion. Tumor resection surgery was performed under cardiopulmonary bypass. The giant tumor was partially detached during the operation, and the thrombus was removed successfully. After the operation, the mental health department of our hospital believed that the diagnosis of schizophrenia was a misdiagnosis. The patient recovered uneventfully and appeared rejuvenated after the operation. A three-year follow-up showed no adverse events since the operation. Conclusions A rare case of cardiac myxoma misdiagnosed as schizophrenia is presented here. When patients complain of chest tightness, we cannot forget the importance of cardiac physical examination and echocardiography. Any diagnosis of schizophrenia requires exclusion of organic disease. Careful and complete resection of the cardiac myxoma is necessary, as it may cause thromboembolism.

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Section: Introductionmentioning

confidence: 88%

Giant cardiac myxoma misdiagnosed as schizophrenia: a case report

Wang

2022

Preprint

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“…The prevalence of IAB increases significantly with age, reaching up to 60% in patients over 65 years of age. In addition to age, other risk factors for its development include arterial hypertension, diabetes, obesity, myocardial ischemia, heart disease, sleep apnea, interventions such as catheter ablation and cardiac surgery [6,[19][20][21][22][23].…”

Section: Epidemiologymentioning

confidence: 99%

Interatrial Block, Bayés Syndrome, Left Atrial Enlargement, and Atrial Failure

Bejarano-Arosemena,

Martínez-Sellés

2023

JCM

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Interatrial block (IAB) is defined by the presence of a P-wave ≥120 ms. Advanced IAB is diagnosed when there is also a biphasic morphology in inferior leads. The cause of IAB is complete block of Bachmann’s bundle, resulting in retrograde depolarization of the left atrium from areas near the atrioventricular junction. The anatomic substrate of advanced IAB is fibrotic atrial cardiomyopathy. Dyssynchrony induced by advanced IAB is frequently a trigger and maintenance mechanism of atrial fibrillation (AF) and other atrial arrhythmias. Bayés syndrome is characterized by the association of advanced IAB with atrial arrhythmias. This syndrome is associated with an increased risk of stroke, dementia, and mortality. Advanced IAB frequently produces an alteration of the atrial architecture. This atrial remodeling may promote blood stasis and hypercoagulability, triggering the thrombogenic cascade, even in patients without AF. In addition, atrial remodeling may ultimately lead to mechanical dyssynchrony and enlargement. Atrial enlargement is usually the result of prolonged elevation of atrial pressure due to various underlying conditions such as IAB, diastolic dysfunction, left ventricular hypertrophy, valvular heart disease, hypertension, and athlete’s heart. Left atrial enlargement (LAE) may be considered present if left atrial volume indexed to body surface is > 34 mL/m2; however, different cut-offs have been used. Finally, atrial failure is a global clinical entity that includes any atrial dysfunction that results in impaired cardiac performance, symptoms, and decreased quality of life or life expectancy.

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