Left Atrial Myxoma as a Neurological Problem: A Case Report and Review

Abstract

A puzzling neurological illness in a patient with a clinically normal heart was explained at autopsy by cerebral embolization from a left atrial myxoma (LAM). Constitutional symptoms associated with LAM were present. Cerebral angiography revealed aneurysms and focal areas of abnormal blushing. Cerebral and cardiac pathology is presented. The surgical follow-up of seven other cases is reported to determine the "curability" of such tumors. We believe that echocardiography should be performed in any case of suspected cerebral embolization even though cardiac symptoms and signs may be absent.

Myocardial infarction as complication of left atrial myxoma

“…Thus, papillar or villous myxomas are more fragile and embolise more often than myxomas with a smooth surface [19]. It is documented that a real shower of emboli can be released [8], so that it is not surprising that emboli from myxomas often cause symptoms at multiple sites [9,17,51,59,61,[62][63]65] and that combined right and left coronary embolism has been documented as well [61]. The clinical focus on acute cerebral or peripheral embolic events may possibly have contributed to an underestimation of concomitant coronary events.…”

Rupture of Cerebral Myxomatous Aneurysm Months After Resection of the Primary Cardiac Tumor

“…The natural history of these lesions, including the types of patients more susceptible, the risk of hemorrhage, the optimum monitoring strategy, and triggers for surgical intervention are all unknown. Patients presenting with cerebral hemorrhage of unknown etiology should undergo cardiac imaging to rule out atrial myxoma, as up to 50% of patients with myxomas present initially with stroke [3,4,10,18,29,30].…”

Cerebrovascular Accident Caused by Embolic Atrial Myxoma

“…1,2,18,19 Fragments of myxomas may embolize and cause signs of peripheral or pulmonary emboli, as well as fever, weight loss, malaise, arthralgias, rash, digital clubbing, and Raynaud's phenomenon. 1,2,[22][23][24][25][26][27][28] Laboratory abnormalities associated with myxomas include anemia, leukocytosis, thrombocytopenia/ cytosis, elevated erythrocyte sedimentation rate (ESR) and CRP. 1,2,22 Rarely, myxomas may become infected; the incidence of cerebral and systemic emboli from infected myxomas is greater than that from non-infected myxomas.…”