Giant Biatrial Myxoma With Few Symptoms-The Odd Between the Rare: A Case Report

Cardiac myxomas are rare and mostly benign. Their thrombogenic surface can lead to embolization, and their size can impair cardiac hemodynamics. Here, we present a unique case of large biatrial myxomas despite mild symptomatology. A female patient (62 years, Caucasian) presented with aggravation of dyspnea and palpitations, with the first occurrence only four months prior to the current clinical presentation. Only moderate changes in standard laboratory markers, including inflammation markers, were observed. Clinical symptomatology and standard transthoracic echocardiography were sufficient for the diagnosis of multiple myxomas (68 × 52 mm in the left atrium and 56 × 53 mm in the right atrium) causing mitral and tricuspid valve inflow obstructions, which were confirmed by subsequent histopathology following surgical resection. The case emphasizes the need for standardized echocardiography at the initial presentation of every patient with dyspnea to exclude cardiac myxoma as a rare cause for the symptoms. The atypical presentation underlines the necessity for serial echocardiographic assessment during follow-up due to possible recurrence.