A case of left atrial myxoma presenting with multiple embolic manifestations

Abstract

Myxomas are the most common
cardiac primary tumours. They account
for 30 to 50 of all benign cardiac
tumours. Seventy five percent of
myxomas occur in the left atrium. The
clinical presentations of cardiac myxoma
varies from asymptomatic to symptoms
of systemic manifestations , primary cardiac
symptoms and those due to embolization
. Tumor embolism is not an uncommon
mode of clinical presentation
and can affect the systemic or pulmonary
circulation, depending upon the location
of the tumor and the patency of the foramen
ovale. Cardiac myxoma is the most
common primary cardiac tumor to produce
tumor emboli. It has been reported
to embolize to any organ or tissue. Large
saddle emboli in the abdominal aorta
have been reported, causing acute lower
limb ischemia.We are presenting a case
of left atrial myxoma, presenting with aortoiliac
and coronary arterial embolic
manifestation . Our patient is a 42 year
old female, presenting with one episode
of syncope, followed by pain, numbness
and weakness of right lower limb. Clinical
examination showed weak lower limb
pulses and a mid diastolic murmur
in the mitral area. Electrocardiogram revealed
symmetrical, deep T wave inversion
in the precordial leads. Echocardiography
showed left atrial myxoma and regional
wall motion abnormality involving the left
anterior descending coronary artery territory,
with mild left ventricular dysfunction.
Peripheral angiogram showed tumour embolus
in the aortoiliac bifurcation. She underwent
successful catheter embolectomy,
followed by surgical removal of the left
atrial tumour.
Keyword :left atrial myxoma, embolisation