Incidental Atrial Myxoma in the Shadow of COVID-19: Coincidence or an Emerging Pattern?

Primary cardiac tumours are a rare entity, and atrial myxomas are a benign subtype usually found in the left atrium. They can present with a wide array of symptoms ranging from cardiac complications to systemic emboli. On the contrary, they can also manifest silently and are detected incidentally, as in this case of an 83-year-old female patient. New lung changes on an X-ray done as a part of an infection screen ultimately led to the diagnosis of an atrial myxoma confirmed by a transthoracic echocardiogram (TTE) and a transoesophageal echocardiogram (TOE). The patient was commenced on anticoagulation and was referred for cardiac surgery. Notably, she had suffered a COVID-19 infection recently, which may have acted as a catalyst in the formation of the tumour. Although a direct causal relationship cannot be established, the literature suggests that COVID-19 infection may lead to chronic inflammation, immune dysregulation, endothelial dysfunction, and other direct viral effects on tissues, all of which could potentially contribute to tumour formation.