1
|
Wong KE, Mani K, Melby SJ, Hou P, Ou J. Stepwise Multimodality Imaging Assists in Atrial Myxoma Diagnosis and Management. JACC: CASE REPORTS 2023; 10:101757. [PMID: 36974044 PMCID: PMC10039379 DOI: 10.1016/j.jaccas.2023.101757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/20/2022] [Accepted: 01/12/2023] [Indexed: 03/17/2023]
Abstract
The case of a 67-year-old man who presented for elective gastroenterology procedures and was in atrial fibrillation is discussed. Transthoracic echocardiography revealed a large atrial mass. Preoperative coronary angiography revealed a heavily vascularized mass. Use of cardiac magnetic resonance identified the cardiac mass as likely an atrial myxoma. (Level of Difficulty: Beginner.).
Collapse
|
2
|
Serrano-Roman J, Saenz-Ancira S, Armendariz-Ferrari JC, Fernandez-Badillo V, Solorzano-Pinot E, Espejel-Guzman A, Berarducci J, Aranda-Fraustro A, Garcia-Cardenas M, Espinola-Zavaleta N. Case Report: Unusual Cause of Chest Pain: A Multi-Image Assessment of a Cardiac Mass. Front Cardiovasc Med 2022; 9:889406. [PMID: 35811740 PMCID: PMC9262377 DOI: 10.3389/fcvm.2022.889406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Myxomas represent the most common benign primary cardiac tumor, they usually grow out of the interatrial septum into the left atrium with a pedunculated base. Intracardiac masses can be found incidentally on imaging studies, but symptomatology may arise secondary to the mass effect, embolization, and valvular function impairment. We present the case of a 75-year-old woman who arrived at the emergency department with atrial fibrillation and NSTEMI segment elevation myocardial infarction (NSTEMI) secondary to a highly vascularized neoplasm visible by coronary angiography and angiotomography. Scarce reports show high quality multi-imaging assessment of significantly vascularized myxomas with such atypical presentation. High-definition imaging studies played a fundamental role in the surgeon’s management of a mass with a complex neovascularization.
Collapse
Affiliation(s)
- Javier Serrano-Roman
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Santiago Saenz-Ancira
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | | | - Valente Fernandez-Badillo
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Enrique Solorzano-Pinot
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Adrian Espejel-Guzman
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Joaquin Berarducci
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Alberto Aranda-Fraustro
- Department of Pathology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Mauricio Garcia-Cardenas
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Nilda Espinola-Zavaleta
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
- Department of Echocardiography, ABC Medical Center I.A.P, Mexico City, Mexico
- *Correspondence: Nilda Espinola-Zavaleta,
| |
Collapse
|
3
|
Lalla S, Kawall J, Seecheran R, Ramadhin D, Seecheran V, Persad S, Seecheran NA. Atrial myxoma presenting as a non-ST-segment elevation myocardial infarction. Int Med Case Rep J 2019; 12:179-183. [PMID: 31354366 PMCID: PMC6590630 DOI: 10.2147/imcrj.s207448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 05/21/2019] [Indexed: 11/23/2022] Open
Abstract
Cardiac myxomas are the most common benign tumors of the heart. We describe the rare phenomenon of myxomatous embolization, resulting in a non-ST-elevation myocardial infarction treated successfully with surgical excision. The routine early use of both transthoracic and transesophageal echocardiography is pivotal in selecting an optimal management strategy for these patients.
Collapse
Affiliation(s)
- Sasha Lalla
- Cardiology Unit, Advanced Cardiovascular Institute, Port of Spain, Trinidad and Tobago
| | - Jessica Kawall
- Department of Clinical Medical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Rajeev Seecheran
- Department of Clinical Medical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Divya Ramadhin
- Cardiology Unit, Advanced Cardiovascular Institute, Port of Spain, Trinidad and Tobago
| | - Valmiki Seecheran
- Department of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago
| | - Sangeeta Persad
- Department of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago
| | - Naveen Anand Seecheran
- Department of Clinical Medical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago
| |
Collapse
|
4
|
Subash S, Thimmarayappa A, Patel GP, Dhananjaya M, Gopal D, Manjunatha N. A Rare Case of Left Atrial Myxoma Vascularity Causing Acquired Coronary Cameral Fistula: Role of Transesophageal Echocardiography. Heart Views 2018; 19:12-15. [PMID: 29876025 PMCID: PMC5965008 DOI: 10.4103/heartviews.heartviews_79_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Left atrial myxoma is the common benign tumor of heart. Coronary arteries may supply these tumor. Considering the vascular nature of the tumor, acquired coronary cameral fistula(CCF) can be a possibility postexcision of the left atrial myxoma. Here, we discuss a case of 53-year-old female patient, who developed acquired CCF, following excision of the tumor and the role of transesophageal echocardiography intraoperatively in diagnosis.
Collapse
Affiliation(s)
- S Subash
- Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
| | - Ashwini Thimmarayappa
- Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
| | - Guru P Patel
- Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
| | - Manasa Dhananjaya
- Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
| | - Divya Gopal
- Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
| | - N Manjunatha
- Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
| |
Collapse
|
5
|
Jung HW, Doh JH, Chang WI. Multi-modality imaging of a left atrial myxoma. SAGE Open Med Case Rep 2017; 5:2050313X17736230. [PMID: 29123666 PMCID: PMC5661666 DOI: 10.1177/2050313x17736230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 09/18/2017] [Indexed: 11/15/2022] Open
Abstract
Objectives Although echocardiography has traditionally been used to diagnose myxoma, invasive or non-invasive coronary angiography can be useful diagnostic tool before surgery. Methods We present a case of an angiographically detected left atrial myxoma feeding from the left circumflex coronary artery. Results The patient underwent open-heart surgery to remove the left atrial myxoma. After ligation of feeding artery, the mass was successfully excised. Conclusion Preoperative coronary angiography can offer additional valuable information moreover detecting coronary artery disease. Because, there is sudden death risk from embolization during invasive coronary angiography, preoperative cardiac computed tomography angiography should be considered to plan the surgery of myxoma.
Collapse
Affiliation(s)
- Hae Won Jung
- Division of Cardiology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang-si, Korea
| | - Joon Hyung Doh
- Division of Cardiology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang-si, Korea
| | - Woo-Ik Chang
- Department of Thoracic Surgery, Inje University Ilsan Paik Hospital, Goyang-si, Korea
| |
Collapse
|
6
|
Akhundova A, Samedov F, Cincin A, Tigen K, Ispir S, Ahiskali AR, Sari I. Giant left atrial myxoma with dual coronary supply presenting with recurrent stroke. Herz 2013; 40:318-20. [PMID: 24189780 DOI: 10.1007/s00059-013-3999-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 09/30/2013] [Indexed: 11/25/2022]
Affiliation(s)
- A Akhundova
- Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | | | | | | | | | | | | |
Collapse
|
7
|
Omar HR. The value of coronary angiography in the work-up of atrial myxomas. Herz 2013; 40:442-6. [PMID: 24173374 DOI: 10.1007/s00059-013-3930-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 07/02/2013] [Accepted: 07/23/2013] [Indexed: 11/26/2022]
Abstract
Atrial myxomas are the most common primary cardiac tumors. They are highly vascular with evidence of neovascularization and a characteristic"tumor blush" in approximately half of the cases. Although the visualization of feeding vessels has several clinical and therapeutic implications, there is still no consensus on the indication of preoperative coronary angiography to assess tumor vascularity except in patients with angina or those older than 40 years to rule out coronary artery disease. Herein, I present a case of an incidentally discovered right atrial mass receiving vascular supply from the right coronary artery. The mass was successfully excised and the diagnosis of cardiac myxoma was confirmed via histopathology. A review of the value of coronary angiography in detecting myxoma neovascularization is provided, which suggests that it can offer additional valuable information that can alter the surgical approach and therefore may be considered prior to myxoma resection.
Collapse
Affiliation(s)
- H R Omar
- Internal Medicine Department, Mercy Hospital and Medical Center, 2525 South Michigan Avenue, 60616, Chicago, Illinois, USA,
| |
Collapse
|
8
|
Wang X, Ren W, Yang J. Neovascularized Myxoma-Causing Abnormal Blood Flow in the Left Atrium Diagnosed by Transesophageal Echocardiography. Echocardiography 2012; 30:E10-2. [PMID: 23002715 DOI: 10.1111/j.1540-8175.2012.01822.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Xiaobing Wang
- Echo Lab; The First Hospital; China Medical University; Shenyang; China
| | - Weidong Ren
- Department of Ultrasonography; Shengjing Hospital; China Medical University; Shenyang; China
| | - Jun Yang
- Echo Lab; The First Hospital; China Medical University; Shenyang; China
| |
Collapse
|