Left atrial myxoma presenting with ventricular fibrillation

Coronary artery embolism with myocardial infarction is a very rare and potentially life-threatening complication of left atrial myxoma. We report the case of a 51-year-old male who presented with chest pain. Whilst awaiting medical review in the emergency department, he collapsed and a cardiac monitor revealed ventricular fibrillation. Following successful resuscitation, a 12-lead electrocardiogram demonstrated anterior myocardial infarction that was initially presumed to be secondary to atheromatous coronary disease. An echocardiogram performed before discharge, however, revealed a mass in the left atrium, which was highly suggestive of a myxoma. His subsequent coronary angiogram demonstrated coronary disease limited to a single lesion within a small first obtuse marginal branch of his circumflex coronary artery. He underwent curative surgery, and histology confirmed the diagnosis of myxoma. We have discussed embolic complications of myxoma and the possible reasons for rarity of coronary embolisation. Emphasis is given to the importance of considering other causes of myocardial infarction in relatively young patients and the important role of early echocardiography following myocardial infarction.