A Rare Reason of Cardiogenic Shock and Acute Myocardial Infarction: Aortic Valve Myxoma

Aortic valve myxoma is a rare benign cardiac neoplasm. The association of aortic valve myxoma with cardiogenic shock and acute myocardial infarction has been reported in few observations. We report the case of a 19-year-old male patient, who underwent chest pain for two weeks, then further examinations indicated a soft spherical mass on the left coronary cusp. The patient had sporadic cardiogenic shock and acute myocardial infarction during the preoperative preparation, and we carried out emergency effective cardiopulmonary resuscitation (CPR), followed by emergency surgical operation for aortic valve tumor. Postoperative pathology showed it was a myxoma. The patient recovered smoothly and was discharged on postoperative day 7. Cardiogenic shock and acute myocardial infarction are very nonspecific, and we should be aware that patients with cardiogenic shock and acute myocardial infarction possibly suffer from aortic valve myxoma.

A Rare Cardiac Neoplasm Presenting as a Chest Pain

Cardiac paragangliomas are the rarest primary cardiac tumours and account for less than one percent of cases. A 24-year-old man presented with complaints of sudden onset of chest pain. The pain started suddenly when he was skiing halfway down the slope and went into a tuck position. Physical examination was significant for elevated jugular venous distension. His electrocardiogram revealed diffuse ST elevation suggestive of acute pericarditis. The echocardiogram revealed pericardial effusion with tamponade physiology. He underwent emergent pericardiocentesis, but the effusion rapidly re-accumulated, requiring a second pericardiocentesis. Computed tomography scan of the chest revealed haemorrhage in the anterior left mediastinum with pericardial extension. The patient underwent emergency cardiac surgery. A 5.0 x 4.5 x 3.2 cm mass, diagnosed histopathologically as paraganglioma, was excised without complication. In all cardiac or extra cardiac tumours we should check pre-operatively for hormonal activity and pre-operative and intra-operative adrenergic blockade must be employed in all secretory paragangliomas.