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Left atrial myxoma and transient ischemic attack: case report
Michelle Franco Macedo de Lima1, Nathália Varano1, Omar Pereira de Almeida Neto2
1Cardiology Nursing Practitioner Fellowship, Federal University of Uberlandia Uberlândia 38400-142, MG, Brazil.
Insights
Cardiac myxomas, though rare, can cause severe issues like stroke. Early diagnosis through thorough clinical investigation is crucial for successful surgical removal and good patient outcomes.
Area of Science:
- Cardiology
- Oncology
Background:
- Cardiac myxomas are rare tumors, most commonly found in the heart.
- Despite benign histology, their intracardiac location can lead to severe complications.
Observation:
- A patient presented with angina and a history of seven Transient Ischemic Attacks (TIAs), aphasia, hemiparesis, dysarthria, and mouth deviation.
- Transesophageal echocardiography revealed a left atrial myxoma.
Findings:
- Surgical resection of the left atrial myxoma was performed using median sternotomy and cardiopulmonary bypass.
- The patient's history of multiple TIAs was a notable diagnostic characteristic.
Implications:
- This case underscores the importance of comprehensive clinical evaluation, including imaging, for diagnosing cardiac tumors.
- Early detection and surgical intervention are vital for preventing severe complications and ensuring favorable outcomes in cardiac myxoma cases.
Abstract:
Cardiac tumors are rare and myxomas are the most prevalent among them. Although it presents benign histology, they may be the cause of severe consequences due to intracardiac location. Nonspecific manifestations may hinder the diagnosis, which can lead to complications, such as changes in cardiac dynamics, thromboembolic events and death. This paper presents a case report of a patient in the emergency department of a high complexity hospital in Minas Gerais State, Brazil, with a clinical history of angina and 7 previous Transient Ischemic Attack (TIA), besides aphasia, right hemiparesis, dysarthria, and mouth deviation. Submitted to transesophageal echocardiography, she was diagnosed with left atrial myxoma. For the treatment of myxoma, a surgical approach was used to resect the myxoma in the left atrium. The standard surgical approach was through a median sternotomy. Cardiopulmonary bypass (CPB) with aortic and bicaval cannulation and moderate hypothermia was used. Myocardial protection was achieved by cold antegrade blood cardioplegia. The patient had notable characteristics for the diagnosis, especially the previous occurrence of seven episodes of TIA. The importance of correct clinical investigation (anamnesis, general and specific physical examination and imaging tests) is notable and a fundamental tool for the diagnosis and early treatment of neoplasia, providing good clinical outcomes.
