Very large left atrial myxoma: an unusual differential diagnosis of bronchial hyper-reactivity

Intra- and paracardiac tumors are rare. Clinical symptoms are typically secondary to mechanical effects of the mass. We describe a patient, who was in good general health, presenting with a 6-month history of unspecific symptoms considered consistent with reccurrent lower airway infections by her primary care physician. A chest X-ray suggested left-atrial enlargement and a questionable mass, which eventually was identified as large left-atrial tumor partially obstructing the mitral orifice. The case demonstrates that even a very large left-atrial tumor, causing intermittent partial obstruction of the mitral valve may present with mild unspecific symptoms.