Cardiac myxoma

An atrial myxoma is a benign tumor of the heart, most commonly

Atrial myxoma
found within the left and then the right atria on the interatrial septum.

Contents
Signs and symptoms
Causes
Diagnosis
Treatment
Prognosis
Micrograph of an atrial myxoma. H&E stain.
Complications
Classification and external resources
See also
References DiseasesDB 1075
MedlinePlus 007273

Signs and symptoms

Symptoms may occur at any time, but most often they accompany a change of body position. Pedunculated myxomas can have a
"wrecking ball effect", as they lead to stasis and may eventually embolize themselves. Symptoms may include:

Shortness of breath with activity

Platypnea – Difficulty breathing in the upright position with relief in the supine position
Paroxysmal nocturnal dyspnea– Breathing difficulty when asleep
Dizziness
Fainting
Palpitations – Sensation of feeling your heart beat
Chest pain or tightness
Sudden Death (In which case the disease is an autopsy finding)
The symptoms and signs of left atrial myxomas often mimicmitral stenosis. General symptoms may also be present, such as:

Cough
Pulmonary edema, as blood backs up into the pulmonary artery , after increased pressures in the left atrium and atrial
dilation
Hemoptysis
Fever
Cachexia – Involuntary weight loss
General discomfort (malaise)
Joint pain
Blue discoloration of the skin, especially the fingers Raynaud's
( phenomenon)
Fingers that change color upon pressure or with cold or stress
Clubbing – Curvature of nails accompanied with soft tissue enlargement of the fingers
Swelling – any part of the body
Presystolic heart murmur[1]
These general symptoms may also mimic those ofinfective endocarditis.
Causes
.[2]
Myxomas are the most common type of primary heart tumor

The tumor is derived from multipotential mesenchymal cells and may cause ball
a valve-type obstruction.

About 75% of myxomas occur in the left atrium of the heart, usually beginning in the wall that divides the two upper chambers of the
heart. The rest are in the right atrium, rarely in the left ventricle. Right atrial myxomas are sometimes associated with tricuspid
stenosis and atrial fibrillation.

Myxomas are more common in women. About 10% of myxomas are passed down through families (inherited), as in Carney
syndrome, where several other abnormalities are observed, such as skin myxomas, pigmentation, endocrine hyperactivity,
schwannomas and epithelioid blue nevi. Such tumors are called familial myxomas. They tend to occur in more than one part of the
heart at a time, and often cause symptoms at a younger age than other myxomas.

Diagnosis
A doctor will listen to the heart withstethoscope. A "tumor plop" (a sound related to movement of the tumor), abnormal heart sounds,
or a murmur similar to the mid-diastolic rumble of mitral stenosis may be heard. These sounds may change when the patient changes
position.

Right atrial myxomas rarely produce symptoms until they have grown to be at least 13 cm (about 5 inches) wide.

Tests may include:

Echocardiogram and Doppler study

Chest x-ray
CT scan of chest
Heart MRI
Left heart angiography
Right heart angiography
ECG—may show atrial fibrillation
Blood tests: A FBC may show anemia and increased WBCs (white blood cells). The erythrocyte sedimentation rate (ESR) is usually
increased.

Play media

Echocardiogram of atrial Echocardiogram showing

myxoma Echocardiogram showing atrial myxoma[3]
atrial myxoma[3]
 Atrial myxoma and Atrial myxoma. H&E Atrial myxoma. H&E Atrial myxoma covered
myocardium. H&E stain. stain. stain. by endothelium. H&E
stain.

Treatment
The tumor must be surgically removed. Some patients will also need their mitral valve replaced. This can be done during the same
surgery.

Myxomas may come back if surgery did not remove all of the tumor cells.

Prognosis
Although a myxoma is not cancer, complications are common. Untreated, a myxoma
can lead to an embolism (tumor cells breaking off and traveling with the
bloodstream), which can block blood flow. Myxoma fragments can move to the
brain, eye, or limbs.

If the tumor grows inside the heart, it can block blood flow through the mitral valve
and cause symptoms of mitral stenosis or mitral regurgitation. This may require
emergency surgery to prevent sudden death.[4]
An embolized fragment of an atrial
myxoma in the iliac bifurcation.
Complications
Arrhythmias
Pulmonary edema
Peripheral emboli
Spread (metastasis) of the tumor
Blockage of the mitral heart valve
Stroke
Fusiform cerebral aneurysms

See also
Myxoma
Interleukin 6
Other primary cardiac tumours include:

Papillary fibroelastoma
Rhabdomyomas
Sarcomas
References
1. Eric J. Topol. The Topol Solution: Textbook of Cardiovascular Medicine(https://books.google.com/books?id=35zSL W
yEWbcC), Third Edition with DVD, Plus Integrated Content W ebsite, Volume 355. Lippincott Williams & Wilkins, Oct
19, 2006; page 223. ISBN 0781770122
2. Vaideeswar, P.; Butany, JW. (Feb 2008). "Benign cardiac tumors of the pluripotent mesenchyme".Semin Diagn
Pathol. 25 (1): 20–8. doi:10.1053/j.semdp.2007.10.005(https://doi.org/10.1053%2Fj.semdp.2007.10.005).
PMID 18350919 (https://www.ncbi.nlm.nih.gov/pubmed/18350919).
3. "UOTW #31 - Ultrasound of the Week" (https://www.ultrasoundoftheweek.com/uotw-31/). Ultrasound of the Week. 30
December 2014. Retrieved 27 May 2017.
4. http://www.jcecho.org/article.asp?issn=2211-4122;year=2018;volume=28;issue=1;spage=59;epage=60;aulast=Barik

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