A Case Presentation Based on Incidental Diagnosis of Atrial Myxoma in a Patient Presenting With Atrial Fibrillation and Suspected Carney Complex

Acute Decompensated Heart Failure Secondary to Left Atrial Myxoma: A Case Report Highlighting Diagnostic Challenges and Multidisciplinary Management

Cardiac myxomas are the most common benign tumors of the heart, with clinical manifestations varying significantly based on tumor size. Symptoms can range from asymptomatic and mild non-specific presentations to severe obstructive cardiac and systemic findings. This case report describes a 68-year-old female patient who presented with acute decompensated heart failure. Diagnostic evaluation revealed a left atrial myxoma causing significant mitral valve obstruction. The patient underwent emergency cardiac surgery for tumor removal, complicated by severe mitral and tricuspid valve regurgitation. Following valve replacement and repair, the patient required extracorporeal life support. Despite these complexities, she achieved significant recovery and was discharged in good condition. At follow-up, she remained asymptomatic with no signs of cardiac decompensation. This case highlights the importance of considering cardiac myxoma as a differential diagnosis in such cases to prevent potential complications.

Misattribution of Dyspnea: Unveiling Atrial Myxoma as the True Culprit

Cardiac myxomas are the most common primary tumors of cardiac neoplasm, predominantly originating within the left atrium (LA). In the present case, a 41-year-old male, identified as a heavy smoker for 15 years, previously diagnosed with chronic obstructive pulmonary disease (COPD) and currently undergoing treatment, presented with a history of dyspnea persisting for one year. Initially, the patient presented to the internal medicine outpatient clinic and was diagnosed with an exacerbation of COPD, but subsequent evaluation revealed the presence of a large mobile pedunculated mass situated in the LA using echocardiography. Subsequently, the mass was surgically excised using a median sternotomy approach. The histopathological examination confirmed cardiac myxoma. This occurrence underscores the significance of considering cardiac myxoma as a plausible differential diagnosis in instances of dyspnea to avert potential complications.

Carney complex- why thorough medical history taking is so important - report of three cases and review of the literature

PURPOSE

To present a new case series and to review the literature on Carney complex (CNC) with an emphasis on highlighting key clinical features of the disease and pointing out possibilities of shortening the diagnostic process.

METHOD

Searches of PubMed, identifying relevant reports up to April 2022.

RESULTS

CNC is a rare, autosomally dominant inherited neoplasia -endocrinopathy syndrome with high clinical variability, even among members of the same family. Data on length of diagnostic process are scarce with numerous case series reporting a diagnostic delay of decades. Suggestions to shorten the diagnostic process includes awareness of the multi-faceted clinical presentations of CNC, thorough history taking of index patients and family members and awareness of diagnostic pitfalls. Importantly, unusual symptom combinations should alert the clinician to suspect a rare endocrinopathy syndrome such as CNC. Already present and coming on the horizon are databases and novel phenotyping technologies that will aid endocrinologists in their quest for timely diagnosis.

CONCLUSION

In this review, we examine the current state of knowledge in CNC and suggest avenues for shortening the diagnostic journey for the afflicted patients.

A Case Report on the Incidental Diagnosis of a Left Atrial Myxoma in a Patient Presenting With Right Shoulder Pain and Inter-scapular Back Pain

Primary cardiac tumors are rare, and myxoma is a rare benign primary cardiac tumor in adults, commonly found within the left atrium. The presentation can vary from patients being asymptomatic to pulmonary embolism or stroke. Smaller atrial myxomas are usually asymptomatic, however, larger ones can cause symptoms such as dyspnea, orthopnea, cough, peripheral edema, palpitations, and fatigue. We present a case report of a 72-year-old patient presenting with right shoulder pain and chest pain on breathing to the accident and emergency department. The patient was complaining of right shoulder pain for five days and pleuritic chest pain for the last 48 hours. Initial electrocardiogram showed normal sinus rhythm, however, repeat electrocardiograms showed atrial fibrillation. An echocardiogram showed a homogeneous, relatively round mass seen in the left atrium, close to the inter-atrial septum, and close to the roof of the left atrium, and the patient underwent surgical removal of the benign tumor.