Echocardiographic diagnosis of left atrial myxoma. Usefulness of suprasternal approach.

Two cases are reported of left atrial myxoma in elderly patients, diagnosed by combined M-mode and bidimensional echocardiography. One patient was an 80-year-old man presenting with typical signs of mitral obstruction by an atrial tumor. His symptoms were erroneously attributed to chronic bronchitis until an echocardiogram was obtained. The other patient was a 70-year-old woman with atrial fibrillation of one year's duration. Left atrial myxoma, although rarely observed in the elderly, may be diagnosed easily by means of echocardiography. Some cases may prove amenable to surgical treatment.

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“…Among the various reports in the literature (1–33) are some series involving the age factor (see Table).…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of left atrial tumors has been made easier by the advent of M‐mode echocardiography (1–4). This safe, inexpensive, noninvasive procedure is now widely available and has led to an increase in the preoperative diagnosis of left atrial myxoma (LAM), the most frequently encountered cardiac tumor (2, 5).…”

mentioning

confidence: 99%

Left Atrial Myxoma in the Elderly: Diagnosis by M‐Mode and Bidimensional Echocardiography

Guillet

Labrousse

et al. 1981

J American Geriatrics Society

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“…As in our case, an initial diagnosis of mitral stenosis is frequently made. Echocardiography has been helpful in establishing the diagnosis (Effert and Domanig, 1959;Schattenberg, 1968;Popp and Harrison, 1969;Wolfe et al, 1969;Finegan and Harrison, 1970;Kostis and Moghadam, 1970;Nicholls et al, 1971;Nasser et al, 1972;Bass and Sharratt, 1973;Martinez et al, 1974;Sung et al, 1975;Zajtchuk et al, 1975;Petsas et al, 1976).…”

Section: Discussionmentioning

confidence: 99%

Left atrial myxoma with aortic regurgitation.

Bourdillon¹,

Monro²,

Johnson³

1978

Heart

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SUMMARY A 59-year-old woman with a left atrial myxoma was shown to have moderate aortic regurgitation. At operation for removal of the myxoma it was found to be attached to the atrial septum close to the aortic root. It is suggested that the aortic regurgitation was caused by distortion of the aortic root caused by traction upon it from the myxoma as it moved downward into the left ventricle in diastole. Observations are made on the echocardiographic findings which helped in the diagnosis of the left atrial myxoma.Rose et al. (1974) described a case in which a left atrial myxoma was associated with aortic regurgitation. They suggested that the aortic valve was regurgitant because of direct trauma to it from the left atrial tumour prolapsing through the mitral valve. We report here a further case of a left atrial myxoma with aortic regurgitation which appeared to result from distortion of the aortic root caused by the downward movement in diastole of the myxoma which had a pedicle attached to the atrial septum close to the aortic root. Case reportThe patient, a 59-year-old white woman, presented with a history of intermittent palpitation and breathlessness on moderate exertion for about 5 years. The palpitation had been persistent for a year. There was no history of rheumatic fever. About 6 months before admission she was diagnosed as having mitral stenosis on the basis of the physical fincdings of a mitral facies, established atrial fibrillation, a soft delayed diastolic murmur, and an early opening snap. The electrocardiogram confirmed the presence of atrial fibrillation and the chest x-ray film showed an enlarged left atrium with some calcification in the region of the mitral valve. She was treated with digoxin, a thiazide diuretic, and oral anticoagulants. Because of persistent symptoms of palpitation and breathlessness she was referred to this hospital for further investigation.Examination again revealed the physical findings 'Present address:

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“…Zu diesem geh6rt ein Kalkschatten im Bereich des rechten Vorhofes, der die Verdachtsdiagnose aufein Myxom stellen lfiBt, da diese zur Verkalkung neigen. Mit der Echokardiographie steht seit der Erstbeschreibung von Effert u. Domanig [11] eine nichtinvasive Methode zur Verffigung, die eine Untersuchung zwischen Mitralklappenvitium und Vorhoftumor erm6glicht [11,13,17,30]. So wurde bei 2 Patienten im eigenen Krankengut primfir die Diagnose eines Vorhoftumors durch Echokardiographie gestellt.…”

Section: Diskussionunclassified

Zur Klinik der Herzmyxome

Saggau

Schmitz

Storch

et al. 1980

Langenbecks Arch Chiv

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Clinical findings, diagnosis, and pathology of heart myxoma are discussed on the basis of personal experience with nine patients. There was a striking variety of signs and symptoms caused by tumor embolization, hemodynamic obstruction, and autoimmunologic reactions. Echocardiography is the method of choice, although angiography may still be necessary in atypical or negative echocardiographic findings. The tumor should be removed as soon as possible after diagnosis. There is danger of tumor embolization in the course of the operation. Long-term results are good, if resection of the tumors is performed before catastrophic complications occur. Morphologically, myxomas are genuine tumors characterized by myxomatous stromata and cells.

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Echocardiographic diagnosis of left atrial myxoma. Usefulness of suprasternal approach.

Cited by 12 publications

References 11 publications

Left Atrial Myxoma in the Elderly: Diagnosis by M‐Mode and Bidimensional Echocardiography

Left Atrial Myxoma in the Elderly: Diagnosis by M‐Mode and Bidimensional Echocardiography

Left atrial myxoma with aortic regurgitation.

Zur Klinik der Herzmyxome

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