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[Clinical characteristics of myxoma of the heart]
Insights
Left atrial myxoma can present with varied symptoms, including embolism or heart failure, often mimicking other conditions. Early echocardiography is crucial for accurate diagnosis, especially in unclear cases.
Area of Science:
- Cardiology
- Oncology
Background:
- Left atrial myxoma is a rare cardiac tumor.
- Diagnosis can be challenging due to nonspecific symptoms.
Observation:
- Three cases of left atrial myxoma are presented.
- Symptoms included cerebral/renal embolisms and congestive heart failure.
- Nonspecific systemic signs like fever and weight loss were common.
Findings:
- Two-dimensional echocardiography and surgical confirmation were used.
- Differential diagnosis includes valvular heart disease, endocarditis, and vasculitis.
- Echocardiography is vital for excluding myxoma in complex cases.
Implications:
- Highlights the diagnostic difficulties of cardiac myxoma.
- Recommends echocardiography for patients with unexplained thromboembolism or fever.
- Emphasizes the importance of considering myxoma in atypical presentations.
Abstract:
The authors describe 3 cases of left atrial myxoma confirmed by two-dimensional echocardiography and at operation. One patient had the symptoms of embolisms to the cerebral and renal vessels in the absence of heart disease, 2 patients presented with the symptoms of congestive heart failure. In one patient, loud first sound as well as systolic and diastolic murmur at the heart apex were documented. The nonspecific manifestations (weight loss, fever, high ESR, dysproteinemia, and rheumatoid factor) were observed in all the cases. The difficulties encountered in the clinical diagnosis of heart myxoma are discussed. The differential diagnosis is made between valvular heart disease and infective endocarditis, systemic vasculitis, cardiomyopathy, etc. Echocardiography to exclude myxoma should be performed in patients with thromboembolism, rheumatic valvular disease, subacute endocarditis (particularly in the absence of the classical symptoms) and in those with fever of unknown origin.