Submit Manuscript | http://medcraveonline.com depends on the size, mobility and location of the AM. It can be asymptomatic, although the typical symptoms involve systemic embolism, heart failure, or non-specific symptoms. Systemic embolism occurs in 25% to 50% of left AM and about half of them travel to the central nervous system [2,3]. The clinical diagnosis of AM is based on imaging methodology like echocardiography, cardiac computerized tomography or cardiac magnetic resonance imaging. These imaging techniques provide detailed information about de structure of the tumor mass, its mobility, size, and myocardial invasion. The histopathological study of the cardiac mass confirms the diagnosis of AM [4]. In order to avoid embolism and other cardiac and systemic complications total surgical resection of the intra-atrial myxoma should be done as soon as possible. Therefore, we are presenting this relatively uncommon disease of a left atrial myxoma developing refractory heart failure which subsides only after surgical resection of this intra-atrial mass.
Case ReportA 59-year-old woman with diabetes mellitus presented with complaints of progressive dyspnea, orthopnoea, inferior limbs oedema that began about 6 months earlier with milder symptoms. She denied previous consultation and treatment. At the time of hospitalization, she was in New York Heart Association (NYHA) functional class IV in sinus rhythm; her blood pressure was 140/90 mmHg. She had mild bilateral basal lung congestion and ascites, mild hepatomegaly and inferior limbs oedema was present. The first heart sound was increased. A soft middiastolic mitral murmur was present, as well as, a grade III/VI pan-systolic mitral murmur heard best at the apex and radiated to the axilla. The conventional electrocardiogram showed sinus rhythm. Transthoracic color-flow Doppler echocardiography revealed a hyper-echogenic large left intra-atrial mass (49 x 44 mm) suggesting an atrial myxoma which was attached to the inter-atrial septum (Figure 1). She also had moderate mitral regurgitation due to valve coaptation failure, mild to moderate left atrial dilatation (48 mm), and moderate pulmonary hypertension with a peak systolic pulmonary artery pressure of 47 mmHg. Mitral valve diastolic velocity was increased to 2.3 m/s with a mean pressure gradient of 10 mmHg. The LV ejection fraction was 69%. Blood tests were within normal limits. The carotid Doppler ultrasound, as well as, the coronary angiogram revealed arteries within normal limits. Despite optimized medical treatment installed for the signs and symptoms of her heart failure there was no improvement in her clinical condition.After obtaining informed consent, the patient underwent successful surgical resection of the intra-atrial mass which consisted of a soft white and yellowish friable myxomatous mass that measured about 5 x 5.5 approximately (Figure 2) which was confirmed to be an atrial myxoma with histological studies
AbstractA 59-year-old woman with diabetes mellitus who presented with complaints of progressive...
