Left ventricular myxoma: Missed vs metastatic

Area of Science:

• Cardiology
• Cardiac Surgery
• Neurology

Background:

• Left ventricular myxomas (LVM) are rare, comprising only 2.5% of cardiac myxomas.
• Recurrence of cardiac myxomas in a different chamber after resection is uncommon.
• Thromboembolic events are a known complication of cardiac myxomas.

Purpose of the Study:

• To report a unique case of left ventricular myxoma occurring after surgical resection of a left atrial myxoma.
• To discuss the diagnostic and management challenges associated with recurrent cardiac myxomas.
• To emphasize the potential for delayed embolic events from cardiac tumors.

Main Methods:

• Case presentation of a 58-year-old male with recurrent cerebrovascular accidents.
• Diagnostic imaging including Magnetic Resonance Imaging (MRI) of the brain, Transthoracic Echocardiogram (TTE), and Transesophageal Echocardiogram (TEE).
• Surgical resection of both the initial left atrial myxoma and the subsequent left ventricular myxoma.

Main Results:

• Initial diagnosis of left atrial myxoma leading to complete surgical resection.
• Recurrent symptoms of transient limb weakness, numbness, and dysarthria due to multiple thromboembolic cerebrovascular accidents.
• Subsequent diagnosis and resection of a left ventricular myxoma one and a half years post-initial surgery.

Conclusions:

• Left ventricular myxoma can occur years after the resection of a left atrial myxoma.
• Recurrent cardiac myxomas pose a significant risk for systemic embolization and cerebrovascular events.
• Vigilant long-term follow-up with echocardiography is crucial for patients with a history of cardiac myxoma.