Left Atrial Myxoma Presenting as Lateral Medullary (Wallenberg’s) Syndrome

Myxomas are benign, primary tumors of the heart. Atrial myxomas can present with a variety of clinical features including dyspnea, orthopnea, pulmonary edema, and pulmonary or systemic emboli. Constitutional symptoms such as fever and weight loss may also be present. We report the case of a young female presenting with headache, facial numbness, and vertigo, who was found to have a posterolateral medullary stroke secondary to a large left atrial cardiac myxoma.

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Management of Cardiac Myxomas

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849239700500308 ◽

1997 ◽

Vol 5 (3) ◽

pp. 158-161

Author(s):

Lim Yeong Phang ◽

Tan Yong Seng

Keyword(s):

Coronary Artery ◽

Left Atrial ◽

Artery Bypass ◽

Cardiac Myxoma ◽

Atrial Myxoma ◽

Right Atrial ◽

Primary Tumors ◽

Left Atrial Myxoma ◽

Singapore General Hospital ◽

Cardiac Myxomas

Cardiac myxomas are benign primary tumors of the heart that require prompt surgical intervention because of the possibility of developing syncope and hemodynamic or embolic complications. From 1 January 1981 to 31 December 1996, 20 patients (11 male and 9 female) underwent surgery for cardiac myxoma at Singapore General Hospital. Nineteen patients had a left atrial myxoma and 1 had a right atrial myxoma. Five patients had concomitant coronary artery disease including one with severe mitral regurgitation. Nine patients presented with progressive dyspnea, 5 with systemic embolus, 2 with syncope, 3 with congestive cardiac failure, and 1 with right ventricular failure. In 6 patients the diagnosis was established by cardiac catheterization and 14 patients were diagnosed by two-dimensional echocardiography. Cardiopulmonary bypass with mild to moderate systemic hypothermia was used for excision of the myxoma in all cases. Five patients had concomitant coronary artery bypass grafting and 2 had concomitant mitral valve replacement. There was no hospital mortality among patients who had only excision of the myxoma, including a patient who had a recurrence of her left atrial myxoma 5 years after the initial excision. There were 2 deaths in patients with coexisting cardiac and other diseases. Surgical excision is recommended for all cases of cardiac myxoma. There is little risk associated with this procedure. All patients should be followed up regularly with echocardiographic assessment as there is a small risk of recurrence.

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Giant left atrial myxoma presenting as cerebral embolism

Journal of Surgical Arts ◽

10.14717/jsurgarts-210209 ◽

2021 ◽

pp. 93-97

Keyword(s):

Left Atrial ◽

Heart Diseases ◽

Atrial Myxoma ◽

Cerebral Stroke ◽

Primary Tumors ◽

Mortality And Morbidity ◽

Left Atrial Myxoma ◽

Cardiac Neoplasms ◽

Systemic Embolization ◽

Rheumatic Heart

Primary cardiac neoplasms are uncommon with an overall incidence of 0.0017 to 0.02%. The majority of these tumors are benign and half of these tumors are myxomas. About 75% of them are located in the left atrium. Acute embolic cerebral stroke is major problem with increased mortality and morbidity. Embolus arising from cardiac origin costitutes about 20% of ischemic strokes. Atrial fibrillation is cause of more than 50% of cardiogenic emboli. Congenital heart diseases, such as atrial septal defect, patent foramen ovale, prosthetic and rheumatic heart valvular disease, dilated cardiomyopathy and endocarditis are predisposing factors for cardiogenic emboli. Emboli from primary tumors of the heart are extremely rare, with an incidence of 0.02 %. Myxoma is a potential source of systemic embolization to the brain or peripheral arteries. Thus, cerebral stroke may be the first manifestation of the presence of left atrial myxoma.

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Prolapsing left atrial myxoma, pulmonary edema and cerebral ischemia

Intensive Care Medicine ◽

10.1007/s001340000805 ◽

2000 ◽

Vol 27 (2) ◽

pp. 446-446 ◽

Cited By ~ 1

Author(s):

Johann Auer ◽

Robert Berent ◽

Thomas Weber ◽

Bernd Eber

Keyword(s):

Cerebral Ischemia ◽

Pulmonary Edema ◽

Left Atrial ◽

Atrial Myxoma ◽

Left Atrial Myxoma

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Localized pulmonary edema in the right upper lobe associated with left atrial myxoma

Clinical Imaging ◽

10.1016/j.clinimag.2009.04.024 ◽

2009 ◽

Vol 33 (5) ◽

pp. 398-401 ◽

Cited By ~ 1

Author(s):

Semin Chong ◽

Eun Jeong Choi ◽

Inyoung Youn ◽

Ju Won Choe ◽

Jae Chol Choi ◽

...

Keyword(s):

Pulmonary Edema ◽

Left Atrial ◽

Atrial Myxoma ◽

Left Atrial Myxoma ◽

The Right

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A Case of Left Atrial Myxoma Presenting as Acute Pulmonary Edema

Journal of the Korean Society of Echocardiography ◽

10.4250/jkse.2000.8.1.93 ◽

2000 ◽

Vol 8 (1) ◽

pp. 93

Author(s):

Yong Bum Cho ◽

Tae Hoon Kim ◽

Chan Il Moon ◽

Jae Woong Choi ◽

Chang Sub Song

Keyword(s):

Pulmonary Edema ◽

Left Atrial ◽

Atrial Myxoma ◽

Acute Pulmonary Edema ◽

Left Atrial Myxoma

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Left Atrial Myxoma and Antiphospholipid Syndrome—A Case Report

International Journal of Angiology ◽

10.1055/s-0041-1740103 ◽

2021 ◽

Author(s):

Mijo Meter ◽

Diana Meter ◽

Toni Ceprnja ◽

Dijana Perkovic

Keyword(s):

Case Report ◽

Antiphospholipid Syndrome ◽

Lupus Erythematosus ◽

Left Atrial ◽

Imaging Modality ◽

Cardiac Myxoma ◽

Atrial Myxoma ◽

Cardiac Tumors ◽

Left Atrial Myxoma ◽

Initial Imaging

AbstractCardiac myxoma (CM) is the most frequent type of primary cardiac neoplasm and is responsible for 58 to 80% of primary cardiac tumors. The antiphospholipid syndrome (APS) occurs most commonly in the systemic lupus erythematosus but it can be also found in other conditions. The coexistence of CM and APS is rarely described in the literature. We report an unusual case of the left atrial myxoma and concomitant APS in a female patient who presented with right-sided hemiplegia. Although rare, we must think about the CM in patients with a newly diagnosed APS and left atrial mass. Nevertheless, we must make a distinction from other possible cardiac structures, especially atrial thrombus. Transthoracic echocardiography is the most frequently used initial imaging modality to detect CM. The aim of this case report was to emphasize that additional imaging modalities and multidisciplinary approach are mandatory in making a proper diagnosis and to choose a further treatment strategy.

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Giant Left Atrial Myxoma: An Unusual Cause of Acute Pulmonary Edema

Journal of the American Society of Echocardiography ◽

10.1016/j.echo.2007.10.016 ◽

2008 ◽

Vol 21 (8) ◽

pp. 978.e1-978.e3 ◽

Cited By ~ 6

Author(s):

Rodolfo Citro ◽

Paolo Masiello ◽

Eduardo Bossone ◽

Gennaro Provenza ◽

Generoso Mastrogiovanni ◽

...

Keyword(s):

Pulmonary Edema ◽

Left Atrial ◽

Atrial Myxoma ◽

Acute Pulmonary Edema ◽

Left Atrial Myxoma

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Giant Left Atrial Myxoma: Cause for Position-Dependent Nocturnal Dyspnea and Cardiac Murmur

The Thoracic and Cardiovascular Surgeon Reports ◽

10.1055/s-0036-1597987 ◽

2017 ◽

Vol 06 (01) ◽

pp. e1-e2 ◽

Cited By ~ 2

Author(s):

Julia Hillebrand ◽

Sven Martens ◽

Andreas Hoffmeier

Keyword(s):

Left Atrial ◽

Clinical Symptoms ◽

Operative Therapy ◽

Atrial Myxoma ◽

Cardiac Murmur ◽

Primary Tumors ◽

Clinical Appearance ◽

Left Atrial Myxoma ◽

Life Threatening ◽

Variable Clinical Presentation

AbstractPrimary tumors of the heart are rare. The majority of them are benign, the left atrial myxoma being the most frequent one. Clinical appearance varies from unapparent to life-threatening complications such as stroke, acute heart failure, or even sudden death. Diagnosis and consecutive surgical treatment strongly depend on the clinical symptoms, but their extent does not correlate with the risk for serious complications. Therefore, patients with variable clinical presentation can be especially endangered. Consequent diagnostic and immediate operative therapy is essential.

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Multiple Cerebral Aneurysms Caused by Cardiac Myxoma

Interventional Neuroradiology ◽

10.1177/159101990701300209 ◽

2007 ◽

Vol 13 (2) ◽

pp. 179-184 ◽

Cited By ~ 24

Author(s):

J. Sedat ◽

Y. Chau ◽

A. Dunac ◽

N. Gomez ◽

L. Suissa ◽

...

Keyword(s):

Left Atrial ◽

Cardiac Myxoma ◽

Cerebral Aneurysms ◽

Atrial Myxoma ◽

Left Atrial Myxoma

A case of multiple cerebral aneurysms caused by left atrial myxoma is reported. We present the details of this case and discuss the hypothetical pathogenesis, radiological aspects and treatment of these neoplastic aneurysms.

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Simultaneously Performed, Totally Endoscopic Left Atrial Myxoma Resection and Lobectomy

The Heart Surgery Forum ◽

10.1532/hsf.2839 ◽

2020 ◽

Vol 23 (3) ◽

pp. E292-E294

Author(s):

Jin Shi ◽

Yong Wang ◽

Qiuyun Wang ◽

Xiaohan Bing ◽

Zengshan Ma

Keyword(s):

Cardiopulmonary Bypass ◽

Cardiac Tumor ◽

Left Atrial ◽

Cardiac Myxoma ◽

Atrial Myxoma ◽

Robotic Assistance ◽

Left Atrial Myxoma ◽

Simultaneous Surgery ◽

The Right ◽

Preoperative Examination

The patient was a 69-year-old male patient with cancer in the right lung and whose preoperative examination showed left atrial myxoma. Simultaneous surgery for both cardiac myxoma resection and a lobectomy by totally endoscopic surgery without robotic assistance was performed. First, the cardiac tumor on the heart was removed using a cardiopulmonary bypass (CPB), then a lobectomy without any new incisions was performed. This case provides evidence that in individual select patients, a left atrial myxoma resection and lobectomy can be performed under total endoscopy at the same time.

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