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Atrial myxoma presenting as infective endocarditis
Gerald Paul Fitzgerald1, John Joseph Coughlan1, Zahir Satti1
1Department of Cardiology, University Hospital Limerick, Limerick, Ireland.
BMJ Case Reports
|March 12, 2018
Summary
A large atrial myxoma infected with Streptococcus viridans was surgically removed from a young student. This successful intervention resolved symptoms of fever and weight loss, leading to a full recovery.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Oncology
Background:
- Atrial myxomas are rare, primary cardiac tumors, often presenting with constitutional symptoms.
- Infective endocarditis is a serious complication, particularly with certain bacterial species.
Observation:
- A 23-year-old student presented with constitutional symptoms including fever, weight loss, and fatigue.
- Cardiac auscultation revealed a diastolic murmur, and echocardiography showed a large mobile mass on the interatrial septum.
- Blood cultures identified Streptococcus viridans, and the mass was suspicious for an infected atrial myxoma.
Findings:
- Echocardiography confirmed a large (5 cm×3 cm) atrial myxoma attached to the interatrial septum, prolapsing into the left ventricle.
- The myxoma was colonized with Streptococcus viridans, indicating bacterial infection.
- Surgical excision of the myxoma was performed successfully, with no obstruction of the mitral valve or left ventricular outflow tract.
Implications:
- This case highlights the importance of considering infected atrial myxoma in young patients with unexplained constitutional symptoms and cardiac murmurs.
- Prompt diagnosis and surgical management are crucial for favorable outcomes and preventing complications like embolism or heart failure.
- Successful treatment underscores the efficacy of surgical resection for large, infected atrial myxomas.
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