Giant cardiac myxoma misdiagnosed as schizophrenia: a case report

Abstract

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.