Left atrial myxoma and transient ischemic attacks: case report

Context: Cardiac tumors are rare and myxomas are the most prevalent between them. Although histologically benign, they may cause severe effects given their intracardiac location. Unspecific symptoms compromise the diagnosis, leading to complications such as changes in the cerebral vascular dynamics. Case report following the CARE guidelines. Case report: A 62-year-old woman was admitted to a high complexity hospital in Minas Gerais, with history of unstable angina, aphasia, right hemiparesis, dysarthria, claiming precordialgia with strong intensity. Complained hyporexia and weight loss during the last month. Medical history of 7 transient ischemic attacks (TIA) in the last two years. Physical examination with no abnormalities. Chest x-ray and transesophageal echocardiogram showed bilateral neovascularization and 4.9 x 2.9 cm dimension mass in the left atrium. Coronary angiography revealed proximal calcification and atherosclerotic plaque occluding 40% of the flux in the middle third of the anterior descending artery, pointing to the coexistence of coronary disease and left atrial myxoma. The occurrence of a TIA was determined and the prescription of an anticoagulant to avoid future embolic events. A surgical approach was necessary. Biopsy concluded myxoid and hyaline-rich stroma tumor, evident vascular system, star-shaped cells isolated or forming small groups, confirming myxoma diagnosis. After a ten-day hospitalization, the patient was clinically stable, and was discharged after health education. Conclusion: Cardiac tumors such as myxomas lead to important cerebral vascular consequences, so that the clinical investigation is essential to the differential diagnosis between a stroke and the TIA, to provide adequate treatment and disease prevention.