Unusual Aspects of Atrial Myxoma

Abstract

Cardiac myxomas are infrequently encountered lesions. Certain aspects of these tumors are unusual and include right atrial location, calcification, valve destruction, hematologic abnormalities, occurrence in children, and familial occurrence. A 12-year-old girl manifesting all of these unusual aspects of myxoma is described and each of the unusual aspects is discussed.

Unique Association of a Rapidly Growing Right Atrial Myxoma in a Child with Double-Outlet Right Ventricle

“…The formation of a myxoma within the right atrium of a child with congenital heart disease has not been previously reported. All reported cases of atrial myxomas have been in patients with structurally normal hearts or with isolated atrial septal defects [3,5,16].…”

Aspergillus Vegetative Endocarditis Complicated with Schizocytic Hemolytic Anemia in a Patient with Acute Lymphocytic Leukemia

“…In our patient, a rapid growth of vegetative lesions might have given rise to a rapid progression of turbulence of blood flow to cause MAHA [14], since our 2-D echocardiography performed one week prior to his death failed to detect such apparent lesions as found at autopsy. Alterna tively, the physical property of rigid valvular lesion [15] might be also related to this unusual hemolytic manifestation.…”

Cardiac Myxoma – Manifestations and Management: Kuwait Experience and Review of the Literature

“…15, 19]. They can be found in the right atrium 18% of the time, and 4% of the time in each of the right and left ventricles [1,20]. Myxomas can occur as biatrial tumors, or rarely as mul tiple tumors simultaneously occurring at dif ferent areas of the heart [20,21].…”

“…Cardiac myx omas can be sporadic, familial or complex. All of our patients had the sporadic variety, which is the most common [ 15], Although myxomas can rarely be asymp tomatic [1,19,22], most present with one or more symptoms of a classic triad of obstruc tive, embolic or constitutional manifestations [19,20,[23][24][25], The symptoms and signs arc mainly dependent on the size and location of the tumor, and the functional derangement caused by it. Constitutional symptoms are due to the presence of the tumor itself [4,[25][26][27], In all of our patients, 2-DE revealed the Med Principles Pracl 1996:5:198-207 characteristic 'to-and-fro' motion across MV of large pedunculated myxomas which filled the left atrium.…”

“…MR noted in 40% of the cases, resulted from impairment of the valve closure by the tumor obstruction, and struc tural damage to the valve apparatus due to frequent tumor impingement [20,23,24]. MV obstruction and regurgitation, as well as the space-occupying effect of the large tumor mass in the left atrium produce dyspnea, pul monary edema, pulmonary hypertension and congestive cardiac failure [16,19,23], At pre sentation, dyspnea was noted in two thirds of our patients and congestive heart failure in half of them.…”