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Coronary Embolization from a Left Atrial Myxoma Containing Malignant Lymphoma Cells

Andrés M Pineda, Christos G Mihos, Francisco O Nascimento

    Texas Heart Institute Journal
    |December 15, 2015
    PubMed

    Insights

    A rare case of myocardial infarction caused by coronary artery embolization from a cardiac tumor is presented. A left atrial myxoma, unexpectedly found to contain lymphoma, was the source of the embolus.

    Area of Science:

    • Cardiology
    • Oncology
    • Pathology

    Background:

    • Systemic embolization from cardiac tumors is common, but coronary artery embolization causing myocardial infarction is rare.
    • Early diagnosis and intervention are crucial for managing acute coronary syndromes.

    Observation:

    • A 50-year-old man presented with severe angina and ST-segment-elevation myocardial infarction.
    • Coronary angiography revealed an acute occlusion of the obtuse marginal branch without evidence of plaque or dissection.
    • Echocardiography identified a large, mobile left atrial myxoma prolapsing into the left ventricle.

    Findings:

    • The patient underwent successful balloon angioplasty for the coronary occlusion.
    • Minimally invasive resection of the left atrial myxoma was performed.
    • Pathologic examination revealed the myxoma harbored a high-grade B-cell lymphoma.

    Implications:

    • This case highlights the importance of considering cardiac tumors as an embolic source in myocardial infarction, even with normal coronary arteries.
    • The co-occurrence of myxoma and lymphoma presents a unique diagnostic and therapeutic challenge.
    • Further research into the relationship between cardiac tumors and thromboembolic events is warranted.

    Keywords:
    Embolizationheart neoplasms/therapy/ultrasonographylymphoma, B-cell/surgerymyocardial infarction/pathologymyxoma/complications/surgeryneoplasms, multiple primarytumor markers, biological/analysis

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