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Left atrial myxoma: new perspectives in the diagnosis of murmur free cases
Insights
Left atrial myxomas can be diagnosed using cross-sectional echocardiography, even without typical cardiac symptoms. Early diagnosis is crucial as absence of symptoms should not delay echocardiography for potential emboli.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Left atrial myxomas are rare tumors that can cause systemic emboli.
- Diagnosis can be challenging due to the absence of specific cardiological signs or symptoms.
Observation:
- Three patients with left atrial myxomas presented with atypical symptoms, including constitutional signs and elevated inflammatory markers (erythrocyte sedimentation rate and C-reactive protein).
- Two patients underwent echocardiography to rule out cardiac sources of systemic emboli, while the third had only constitutional symptoms.
Findings:
- Cross-sectional echocardiography successfully diagnosed left atrial myxomas in all three patients.
- Two patients with myxomas underwent successful surgical excision.
- One patient with massive embolization died during emergency surgery.
Implications:
- Cross-sectional echocardiography is the gold standard for diagnosing atrial myxomas.
- The absence of cardiac symptoms should not deter clinicians from referring patients for echocardiography, especially when systemic emboli are suspected.
Abstract:
No cardiological signs or symptoms were seen in three patients with left atrial myxomas. The diagnosis was established by cross sectional echocardiography. In two patients this investigation was performed to exclude a cardiac source of systemic emboli. The third patient had constitutional signs only. All three had raised erythrocyte sedimentation rates and C reactive protein concentrations. In two patients the myxomas were successfully excised; the third patient who had presented with massive peripheral and central embolisation died during emergency operation. Cross sectional echocardiography is the technique of choice for detecting atrial myxomas and the absence of the cardiological signs should not preclude referral for diagnostic echocardiography.