Infected cardiac myxoma: an updated review

Abstract

OBJECTIVE This study aims to present an updated clinical picture of the infected cardiac myxoma. Revankar & Clark made a systematic review of infected cardiac myxoma based on the literature before 1998. Since then, there has not been any updated information describing its recent changing trends.METHODS A comprehensive literature search of infected cardiac myxoma was conducted on MEDLINE, Highwire Press and Google between 1998 and 2014.RESULTS In comparison with Revankar & Clark's series, the present series disclosed a significantly decreased overall mortality. It is believed that refinement of the prompt diagnosis and timely management (use of sensitive antibiotics and surgical resection of the infected myxoma) have resulted in better outcomes of such patients.CONCLUSION The present series of infected cardiac myxoma illustrated some aggravated clinical manifestations (relative more occasions of high-grade fever, multiple embolic events and the presence of refractory microorganisms), which should draw enough attention to careful diagnosis and treatment. In general, the prognosis of infected cardiac myxoma is relatively benign and the long-term survival is always promising.

Atrial myxoma presenting as infective endocarditis

“…10 An updated review of 39 cases between 1998 and 2014 had similar findings, with infected myxomas having relative more occasions of high-grade fever, multiple embolic events and the presence of refractory microorganisms. 11 Prognosis postexcision is excellent, with survival rates consistently quoted at greater than 90% with reoccurrence rates of approximately 5%. 12 13 There are no definitive guidelines but yearly surveillance echocardiography is a reasonable strategy as early diagnosis and intervention reduces potential complications.…”

Cardiac myxoma presenting with fever of unknown origin

“…In patients with cardiac myxoma presenting with FUO, 26.9% of the patients only manifested constitutional symptoms and 14.8% were also infected cardiac myxomas [10]. The rarity of FUO in cardiac myxoma patients often causes a delayed diagnosis.…”

Left Atrial Myxoma Masquerading as Viral Flu

“…When patients with a left atrial myxoma present with an embolic stroke, the stroke is usually related to the friability and mobility of the tumor rather than its size ( 1,5,8 ). Rarely, cardiac myxoma can be infected, and in these circumstances they are more prone to systemic embolization ( 7,9 ).…”