ST-Segment Elevation Myocardial Infarction and Right Atrial Myxoma
Maximilian Vondran1,2, Tamer Ghazy1, Terézia Bogdana Andrási1
1Department of Cardiac and Thoracic Vascular Surgery, Philipps-University Hospital Marburg, Baldingerstraße, Marburg, Germany.
Insights
A giant right atrial myxoma and a persistent foramen ovale can cause ST-elevation myocardial infarction (STEMI). Emergency echocardiography is crucial for diagnosing cardiac tumors in acute coronary syndrome patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Interventional Cardiology
Background:
- Cardiac myxoma is the most common primary cardiac tumor.
- While typically benign, cardiac myxomas can lead to severe complications like embolization.
- Right atrial myxomas are rare but can present with significant clinical manifestations.
Observation:
- A case of ST-elevation myocardial infarction (STEMI) in a 64-year-old male is presented.
- The patient had a giant right atrial myxoma and a patent foramen ovale (PFO).
- The STEMI was associated with the presence of the cardiac tumor and PFO.
Findings:
- Emergency percutaneous coronary intervention was performed.
- Subsequent cardiac surgery successfully removed the right atrial myxoma.
- The combination of right atrial myxoma and PFO was implicated in causing the STEMI.
Implications:
- This case highlights the potential for cardiac myxomas, especially with a PFO, to cause acute coronary syndromes.
- Urgent echocardiography is recommended for all patients presenting with acute coronary syndrome to rule out cardiac tumors.
- Early diagnosis and intervention are critical for managing patients with cardiac myxoma presenting as STEMI.
Abstract:
Background Cardiac myxoma is the most common primary cardiac tumor. Although benign, it can cause life-threatening complications due to embolization. Case Presentation We describe an ST-elevation myocardial infarction (STEMI) involving a giant right atrial myxoma and persisting foramen ovale (PFO) in a 64-year-old male patient and report on emergency percutaneous interventional therapy and subsequent cardiac surgery to remove the right atrial myxoma. Conclusion A right atrial myxoma, combined with a PFO, can cause a STEMI. Therefore, every acute coronary syndrome patient should undergo ultrafast exploratory emergency echocardiography to protect the physician from unpleasant surprises.
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