Clinical Characteristics and Outcomes of a Cohort of Multiethnic Asian Patients with Cardiac Myxoma

Cardiac myxomas are the most common primary cardiac tumours. The overall prevalence is very low and up to 25% present asymptomatically. In Asia, the data on myxomas is limited. Therefore, we aimed to outline a multi-ethnic Asian population of cardiac myxoma patients. We included all index echocardiographic diagnoses of myxoma at a tertiary cardiovascular referral centre from May 2004 to April 2021. A retrospective review of all patients' medical records was conducted. Data including patient characteristics, clinical presentation, imaging, treatment, and outcomes were collected and analysed. A total of 64 patients (mean age 66.4 years old, male 61%) were diagnosed with cardiac myxoma. The incidence of major adverse cardiovascular events (MACE) was 10 (16.1%) and 10-year mortality was 11 (17.2%). The proportion of asymptomatic patients (30.2%) increased from 15.4% before 2012 to 35.3% after 2012. Pre-existing chronic kidney disease and ischaemic heart disease were independently associated with increased risk of mortality and MACE (p-values < 0.05). Most patients (75.0%) underwent surgical resection. This was associated with a decreased risk of mortality and MACE (p-values < 0.05). The increase in the diagnosis of asymptomatic patients over the years could be attributed to increased opportunistic screening and incidental pickups. Surgical resection was associated with better outcomes. However, the poor outcomes of non-operated patients may be due to the concurrent comorbidities that preclude surgery.