Mitral Annulus Myxoma Extending into Left Atrium and Left Ventricle with Severe Mitral Regurgitation as a Pre-Operative Finding, a Rarity

authors:

avatar Hamza Abdur Rahim Khan 1 , avatar Atiya Hameedullah 1 , * , avatar Omar Irfan 1 , avatar Muhammad Tariq 2 , avatar Saulat Hasnain Fatimi 2

Medical College, Aga Khan University, Karachi, Pakistan
Department of Surgery, Division of Cardiothoracic Surgery, Aga Khan University, Karachi, Pakistan
International Cardiovascular Research Journal: Vol.11, issue 2; e11189
published online: June 30, 2017
article type: Case Report
received: May 31, 2017
accepted: January 04, 2017

how to cite: Abdur Rahim Khan H , Hameedullah A , Irfan O , Tariq M , Hasnain Fatimi S . Mitral Annulus Myxoma Extending into Left Atrium and Left Ventricle with Severe Mitral Regurgitation as a Pre-Operative Finding, a Rarity. Int Cardiovasc Res J. 2017;11(2):e11189. 

Abstract

Cardiac tumors constitute 0.2% of all tumors. Primary cardiac tumors occur infrequently with an incidence of 0.0017-0.19% as shown by autopsies performed in non-selected populations. Among these tumors, cardiac myxomas are most commonly encountered, with left atrial myxomas being more prevalent than right atrial ones. The classic triad of symptoms, of which at least one is present in a patient with atrial myxoma, are obstructive traits including dyspnea and syncope, constitutional symptoms such as fever and anorexia, and thromboembolic events. Surgical resection confers almost definitive treatment with recurrence rates being as low as 3%. A 50-year-old woman referred to the Emergency Unit with a sudden episode of chest heaviness and shortness of breath. There was no significant physical examination finding and all routine lab investigations were normal. She underwent an angiography that revealed tight left anterior descending artery stenosis. An angioplasty was also performed, but she had an episode of pre-syncope immediately. Then, echocardiogram was performed that showed a large left atrial myxoma causing severe mitral regurgitation. Thus, urgent open heart surgery was planned. The myxoma was identified and excised, the mitral annulus resolved, and normal flow was restored. The patient was then discharged home and followed up for 2 months with no complaints. In the current study, we reported a rare case where mitral regurgitation was caused by a left atrial myxoma. Our report highlighted the diverse clinical spectrum of myxoma and emphasized the need for early echocardiographic diagnosis to aid in identification of myxoma followed by early surgical intervention.

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