Cardiac myxoma - clinical experience in 24 patients

Fang, Ber-Ren; Chiang, Cheng-Wen; Hung, Jui‐Sung; Lee, Ying-Shiung; Chang, Chau-Shiung

doi:10.1016/0167-5273(90)90123-m

Cited by 27 publications

(21 citation statements)

References 14 publications

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“…3,11,12 In our large survey, elevation of CRP was the most commonly observed manifestation (39% of cases), followed in descending order by elevation of gammaglobulin, fever, and weight loss. Several previous studies found that constitutional signs in patients with cardiac myxoma disappeared after the tumor was removed.…”

Section: Discussionmentioning

confidence: 78%

Characteristics of cardiac myxoma with constitutional signs: A multicenter study in Japan

Endo

Ohtahara

Kinugawa

et al. 2002

Clinical Cardiology

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Background: A relationship between constitutional signs in patients with cardiac myxoma and interleukin‐6 has been Noted. However, there is little information about characteristics of cardiac myxomas associated with constitutional signs. Hypothesis: The objective of this study was to clarify the characteristics of myxoma patients who had constitutional signs. Methods: Questionnaires were sent to cardiology or cardiovascular surgery divisions at university hospitals throughout Japan. Constitutional signs were considered present when a patient had fever, weight loss, or elevations of C‐reactive protein or gammaglobulin. In addition, interleukin‐6 concentrations were evaluated in some patients. Results: Data were obtained in 249 patients with primary cardiac tumors (204 myxomas, 15 other primary benign tumors, and 30 primary malignant tumors), confirmed histologically between 1993 and 1996. Fever and weight loss were observed in 15 and 6% of patients with myxoma, respectively, while C‐reactive protein and gammaglobulin were increased in 39 and 21%, respectively. This amounted to a prevalence of constitutional signs in 49%. All constitutional signs disappeared after tumor resection. Age, gender, tumor site, and frequency of thrombosis did Not differ between patients with and without constitutional signs. Tumors associated with constitutional signs were significantly more likely to be large, multiple, or recurrent than those unassociated with constitutional signs. Conclusions: Constitutional signs are present in about half of patients with myxoma. Large or multicentric tumors are likely to induce constitutional signs, which are reversible upon resection. These might suggest that constitutional signs result when interleukin‐6 concentrations exceed a certain threshold.

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Section: Discussionmentioning

confidence: 78%

Characteristics of cardiac myxoma with constitutional signs: A multicenter study in Japan

Endo

Ohtahara

Kinugawa

et al. 2002

Clinical Cardiology

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“…7,13,17,29,32,54,55,72,[79][80][81][82][83][84][85] Anemia is generally normochromic or hypochromic, but hemolytic anemia may also be found because of the mechanical destruction of erythrocytes by the tumor 4,12,13,17,24,29,54,55,72,73,86 ; polycythemia has been reported as well. 12,13,55,86,87 Less common findings are leukocytosis, thrombocytopenia, cyanosis, clubbing, and Raynaud's phenomenon.…”

Section: General or Constitutional Manifestationsmentioning

confidence: 99%

“…The cardiac rhythm is usually normal sinus; in contrast to the findings in mitral valve disease, atrial fibrillation is uncommon. 4,29,52,85 Long-term electrocardiographic monitoring may document supraventricular arrhythmias in atrial tumors and ventricular arrhythmias in ventricular tumors.…”

Section: Iagnostic T Estsmentioning

confidence: 99%

“…Because of the availability of other imaging methods, the role of angiocardiography in the diagnosis of cardiac tumors has declined in importance. 64,85,100 In general, however, coronary arteri- ography is an undisputed component of the preoperative evaluation of patients over 40 years of age, to rule out concomitant coronary artery disease. Arteriography may show that tumor vessels are supplied from branches of the left or right coronary artery.…”

Section: Ct and Mrimentioning

confidence: 99%

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Cardiac Myxomas

1995

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Although cardiac myxomas are histologically benign, they may be lethal because of their strategic position. They can mimic not only every cardiac disease but also infective, immunologic, and malignant processes. Myxomas must therefore be included in the differential diagnosis of valvular heart disease, cardiac insufficiency, cardiomegaly, bacterial endocarditis, disturbances of ventricular and supraventricular rhythm, syncope, and systemic or pulmonary embolism. The symptoms depend on the size, mobility, and location of the tumor. Echocardiography, including the transesophageal approach, is the most important means of diagnosis; CT and MRI may also be helpful. Coronary arteriography in patients over 40 years of age is generally required to rule out concomitant coronary artery disease. Surgical removal of the tumor should be performed as soon as possible; the long-term prognosis is excellent, and recurrences are rare. In follow-up examinations as well, echocardiography is essential.

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“…Myxomas may manifest with a variety of signs and symptoms such as dyspnoea, systemic emboli, palpitation and constitutional signs, including fever, weight loss and arthralgias. They may also complicate by syncope usually occurring in upright position and due to obstruction of a cardiac valve orifice [2,3]. Syncope and cerebral emboli, which occurred in this patient, are rare manifestation of cardiac myxoma.…”

mentioning

confidence: 81%