Right atrial myxoma with right to left shunt and coronary artery disease

Right Atrial Myxoma with Coexistent Coronary Artery Disease - A Rare Combination

Atrial myxomas are the most common primary heart tumors. Two-dimensional echocardiography is the diagnostic procedure of choice. The majority of myxomas are located in the left atrium. Myxoma in the right atrium is an uncommon location. The co-occurrence of right atrial myxoma with atherosclerotic coronary artery disease (CAD) is uncommon. In our case, right atrial myxoma was associated with CAD, which makes it a unique case because very few cases of right atrial myxoma coexistent with CAD are described in literature.

Effect of abnormal right heart structures on the diagnosis of pulmonary hypertension

The diagnosis of pulmonary hypertension (PH) requires a right heart catheterization (RHC) that reveals a mean pulmonary artery pressure ≥ 25 mmHg. The pulmonary artery catheter traverse the right atrium and ventricle on its way to the pulmonary artery. The presence of abnormal right heart structures, i.e. thrombus, vegetation, benign or malignant cardiac lesions, can lead to complications during this procedure. On the other hand, avoidance of RHC delays the diagnosis and treatment of PH, an approach that might be associated with worse outcomes. This paper discusses the impact of right heart lesions on the diagnosis of PH and suggests an approach on how to manage this association.

Cardiac magnetic resonance imaging and a rare case of an atrial myxoma causing an atrial septal defect

A 40 year-old athletic woman presented with worsening dyspnea on exertion over the preceding several months. Chest radiograph showed borderline cardiomegaly and subsequent echocardiography demonstrated a 5.0-cm left atrial mass as well as left-to-right interatrial shunting through a patent foramen ovale. Cardiac magnetic resonance imaging was performed, which demonstrated signal characteristics consistent with an atrial myxoma. The patient then underwent urgent surgical treatment with good technical and clinical outcome. Histologic examination confirmed an atrial myxoma. Cardiac magnetic resonance imaging was valuable in characterizing the nature of the atrial mass and patent foramen ovale, helping guide the surgical approach.

Atrial myxoma with coexistent coronary artery disease: a report of two cases

The age at presentation and the symptoms of atrial myxomas and coronary artery disease can be similar. At times, the two lesions coexist. Operative strategy needs to be carefully planned when combined surgical treatment is contemplated. In the present paper, two cases of concomitant atrial myxoma and atherosclerotic coronary artery disease are reported. The first patient had a left atrial myxoma with triple-vessel coronary artery disease. The other had a right atrial myxoma and needed two bypass grafts. Both patients had a satisfactory outcome.

Papillary fibroelastoma of the tricuspid valve in association with an atrial septal defect: report of a case

Although papillary fibroelastoma is rare, it is the most common primary tumor of the heart valves. We describe herein the case of a 64-year-old woman scheduled to undergo atrial septal defect (ASD) repair, in whom a papillary fibroelastoma of the tricuspid valve was diagnosed by transesophageal echocardiography (TEE). Surgical resection of the papillary fibroelastoma at the time of ASD repair prevented the fatal embolization sometimes associated with this lesion. Thus, intraoperative TEE played an important role in identifying the location of the tumor and its anatomic attachment, and in assessing the adequacy of surgical treatment.