Total Detachment of Cardiac Myxoma Causing Saddle Embolization and Mimicking Aortic Dissection

Abstract

SUMMARYA 51-year-old male presented with sudden onset lower abdominal pain followed by weakness of both legs. Examination revealed blood pressure of 220/130 mmHg, with a grade 2/6 systolic murmur audible at the apex of the heart, and absence of both femoral arterial pulses. Two-dimensional and transesophageal echocardiography showed no evidence of intracardiac tumor or dissection of the ascending and thoracic aorta. Moreover, an aortogram demonstrated total occlusion of the abdominal aorta just below the renal arteries. A myxomatous-like material occupying the abdominal aorta just above the bifurcation of the common iliac arteries was discovered during surgery. Histologic examination of the embolic material confirmed the diagnosis of myxomatous embolus. One year after the embolic episode, the patient was well and two-dimensional and transesophageal echocardiography revealed no evidence of residual intracardiac tumor. (Jpn Heart J 2004; 45: 359-363)

Left Atrial Myxoma: Presentation with Acute Aortic Occlusion and ‘Resolution’ of the Primary Tumor

“…The phenomenon of complete embolization of an atrial myxoma in the aortoiliac region where no primary heart tumor can be detected is reported in a few case reports (6,7). Complete embolization in two periods most likely happened in the case report described here.…”

A Catastrophic Picture; Recurrent and Multiple Embolisms of Left Atrial Myxoma: Case Report

“…4 Em bo lic phe no me non in car di ac myxo ma is common, with the in ci den ce ran ging from 30% to 40%. 5 The em bo li ge ne rally disp lay a pre di lec ti on for the cen tral ner vo us system, 6 but can al so af fect ot her or gans such as the li ver, sple en, kid ney, re tina, co ro nary ves sels, and dis tal ar te ri al tre e. 5 In a ret ros pec ti ve re vi ew of 112 pa ti ents by Pi ne de et al, 7 it was fo und that the most com mon ini ti al presen ting symptoms of at ri al myxo ma we re re la ted to mit ral val ve obs truc ti on; ho we ver, 33 pa ti ents pre sen ted with signs of em bo lism, inc lu ding 24 to the cen tral ner vo us system. 2 The ot her stu di es suggest that at ri al myxo ma oc curs in 0.5% of acu te stro ke pa ti ents, wo men in the fifth de ca de being at gre a test risk.…”

Left atrial myxoma combined with coronary artery disease in an elderly patient

“…The size of the myxoma is directly proportional to the severity of the patient's symptoms [4]. Coexistence of coronary artery disease and myxoma is a rare condition and, it is reported in a limited number of case reports [5][6][7][8]. We describe a rare case with simultaneous left atrial myxoma and coronary artery disease in an elderly woman with shortness of breath and chest pain.…”