Giant left atrial myxoma mimicking severe mitral valve stenosis and severe pulmonary hypertension

Mouine, Najat; Asfalou, Iliyasse; Raissouni, Maha; Benyass, Aatif; Zbir, E.

doi:10.1186/1755-7682-6-13

Cited by 8 publications

(7 citation statements)

References 8 publications

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“…From numerous studies, it appears that the only clinical manifestation reported in mitral stenosis but not in left atrial myxoma is paralysis of the left recurrent laryngeal nerve (Ortner's syndrome), hence recognized as a distinctive symptom of mitral stenosis . Myxoma may vary in size from a few mm to 14 cm in diameter; ‘giant’ or ‘colossal’ myxomas may mimic severe mitral valve stenosis and cause severe pulmonary hypertension . Similarly, the reported growth rate of left atrial myxomas varies from no growth to 1.3–6.9 mm/month in diameter .…”

Section: Gross Pathologymentioning

confidence: 99%

The mysterious pathways of cardiac myxomas: a review of histogenesis, pathogenesis and pathology

2014

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Cardiac myxoma is the most common benign cardiac tumour, localized generally in the left atrium. The majority of cardiac myxomas occur sporadically, while a relatively small proportion of cases develop as a part of Carney complex syndrome. Currently, the histogenesis of myxoma is poorly understood; however, the mesenchymal and endothelial properties of myxoma cells suggest that a clearer understanding of tumour origins can be achieved through a detailed investigation of heart development and endocardial histogenesis. Growing evidence appears to indicate the reactivated expression in cardiac myxoma of genes encoding heart precursor markers, although the exact mechanisms have not yet been described. In this paper we review the most recent scientific literature concerning cardiac embryology and relate this to recent advances in our understanding of the histogenesis of cardiac myxoma. Moreover, given that much of the literature regarding myxoma is of single case reports, we review progress in our knowledge of the pathology and pathogenesis of this condition.

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Section: Gross Pathologymentioning

confidence: 99%

The mysterious pathways of cardiac myxomas: a review of histogenesis, pathogenesis and pathology

2014

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“…LA myxomas may cause severe mitral valve stenosis. 22 Atrial arrhythmias such as AF or flutter may also be identified in patients with atrial myxoma. 23 Large myxomas may almost fully occupy the atrial outflow and lead to increased LA pressure.…”

Section: Discussionmentioning

confidence: 99%

Postoperative atrial fibrillation in patients with left atrial myxoma: cardiovascular topic

Şahin

Tigen

Cihan

et al. 2015

CVJA

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SummaryIntroductionThe aim of this study was to determine the factors associated with postoperative atrial fibrillation (AF) in patients with left atrial (LA) myxoma.MethodsThirty-six consecutive patients with LA myxoma (10 men, mean age: 49.3 ± 15.7 years), who were operated on between March 2010 and July 2012, were included in this retrospective study. Pre-operative electrocardiograms and echocardiographic examinations of each patient were reviewed.ResultsPostoperative AF developed in 10 patients, whereas there was no evidence of paroxysmal AF after resection of the LA myxoma in the remaining 26 patients. The patients who developed AF postoperatively were significantly older than those who did not develop AF (median: 61.5 vs 46 years; p = 0.009). Among the electrocardiographic parameters, only P-wave dispersion differed significantly between postoperative AF and non-AF patients (median: 57.6 vs 39.8 ms, p = 0.004). Logistic regression analysis revealed P-wave dispersion (OR: 1.11, 95% CI: 1.003–1.224, p = 0.043) and age (OR: 1.13, 95% CI: 1.001–1.278, p = 0.048) as independent predictors of postoperative AF in our cohort of patients.ConclusionsP-wave dispersion is a simple and useful parameter for the prediction of postoperative AF in patients with LA myxoma.

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“…LAM inflammatory process gives rise to a rapid sequence of chordal thickening and retraction, commissural fusion and finally thickened leaflets [incomplete opening and closure of the leaflets] with an enlarged annulus which eventually leads to regurgitation. Though an uncommon relation to the underlying processes involved with LAM throughout its development until therapy, pathologist has confirmed postoperatively the pathological component of LAM to be a spindle tumor with mucus production histologically made up of fusiform, stellate, and or polygonal cells [42][43][44][45] and histologically associated with interleukin-6 [46].…”

Section: Rheumatic Heart Diseasementioning

confidence: 99%

Mitral Valve Insufficiency, a Constituent of Left Atrial Myxoma: Pathobiology, Physiopathology, and Pathophysiology of Left Atrial Myxoma; Are Long-Term Results Still Feasible?

Daniel¹,

Zhou²,

Zhang³

et al. 2018

Structural Insufficiency Anomalies in Cardiac Valves

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Mitral valve is a complex cardiac structure whose function depends on a proper synchronization between each mitral valve apparatus. Considerable headway over the years has been made toward unraveling the theoretical aspects which unifies the dynamic function, structural properties, and pathobiological, pathophysiological performance of the cardiac valves. However, the aspect of mitral valve regurgitation caused by left atrial myxoma still remains a gray area in the field as the mechanism(s) behind the masked and/or the resultant mitral valve regurgitation in relation to left atrial myxoma remains elusive. Although the regurgitations in most scenarios are masked due to the presence of the myxoma itself, however, both invasive and noninvasive techniques employed cannot ascertain if the regurgitation seen is a resultant or concomitant factor as the underlying pathological processes causing mitral valve regurgitation play key roles in the disease pathology as it could be a series of activated measures caused by the myxoma itself. Elucidating the role left atrial myxoma plays in mitral valve regurgitation is critical to improving our understanding as the aim of this chapter is to discuss the current knowledge of mitral valve regurgitation caused by left atrial myxoma in succinct with the elusive underlying pathological sequential cascade activated due to the presence of this neoplasm.

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Giant left atrial myxoma mimicking severe mitral valve stenosis and severe pulmonary hypertension

Cited by 8 publications

References 8 publications

The mysterious pathways of cardiac myxomas: a review of histogenesis, pathogenesis and pathology

The mysterious pathways of cardiac myxomas: a review of histogenesis, pathogenesis and pathology

Postoperative atrial fibrillation in patients with left atrial myxoma: cardiovascular topic

Mitral Valve Insufficiency, a Constituent of Left Atrial Myxoma: Pathobiology, Physiopathology, and Pathophysiology of Left Atrial Myxoma; Are Long-Term Results Still Feasible?

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