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Angina pectoris in a patient with protein C deficiency and deep vein thrombosis: thrombus versus myxoma?

Shilpa Kshatriya1, Daniel Villarreal, Kan Liu

  • 1SUNY Upstate Medical University and Veterans Affairs Medical Center, Syracuse, New York 13202, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|April 28, 2011
PubMed

Insights

This study reports a rare case of cardiac myxoma presenting as typical angina, a symptom not previously documented. Cardiac catheterization proved crucial in differentiating myxoma from thrombus, aiding diagnosis and treatment.

Area of Science:

  • Cardiology
  • Oncology

Background:

  • Cardiac myxomas are primary heart tumors, often benign, that can cause diverse clinical symptoms.
  • Typical angina is an unusual presentation for cardiac myxoma.

Observation:

  • A 55-year-old male with a history of hypertension, diabetes, protein C deficiency, and deep vein thrombosis presented with typical angina.
  • Imaging studies (CT, TEE) revealed a mobile left atrial mass, indistinguishable between thrombus and myxoma.
  • Cardiac catheterization demonstrated tumor neovascularization, suggesting myxoma.

Findings:

  • Surgical resection and subsequent pathology confirmed the left atrial mass as myxoma.
  • This case highlights typical angina as a potential, albeit rare, primary manifestation of cardiac myxoma.
  • Noninvasive imaging had limitations in definitive diagnosis, especially with hypercoagulable conditions.

Implications:

  • Cardiac catheterization offers diagnostic value in differentiating myxoma from thrombus and detecting potential embolization.
  • Anticoagulation is vital for long-term management in myxoma patients with coexisting hypercoagulable disorders.
  • This case expands the clinical spectrum of cardiac myxoma presentations.

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