Unusual echographic manifestations of right and left heart myxomas

Although echocardiography has provided a useful noninvasive means for detecting cardiac myxomas, the ultrasound manifestations of these tumors may be variable. We describe our experiences with unusual echographic features encountered in left and right heart myxomas. Thus the left atrial tumor may be manifested predominantly by multiple, discrete, linear echoes behind the mitral valve, the anterior leaflet of which may exhibit an abrupt mid-systolic posterior movement. In right heat myxomatous tumor arising from the septal tricupsid leaflet and adjacent interventricular septum, the echographic characteristics include a cloud of echoes throughout the cardiac cycle in the right ventricular outflow tract which are present in the right ventricle body only during relaxation and are anterior to the tricuspid valve in early diastole. Therefore, discrete linear echoes may be the principal echographic presentation of left atrial myxoma, and special attention should be focused on all areas of the tricuspid valve and right ventricle by ultrasound in patients in whom diagnosis of myxoma is suspected.