Diagnostically Challenging Cardiac Myxoma Presenting as Acute Myocardial Infarction

Primary cardiac tumors are rare. Among them, myxomas are the most common, and clinical presentations can be variable.

A 31-year-old woman presented with sudden-onset chest pain and syncope. The electrocardiogram demonstrated self-terminating ventricular tachycardia and inferior ST-segment elevation. She was found to have a left atrial myxoma with embolization to the coronary arteries and underwent successful emergency resection.

The diagnosis of stress cardiomyopathy was ruled out by echocardiography. Angiography did show an abrupt change in vessel diameter between normal and diseased segments, which suggested type 2 spontaneous coronary artery dissection. However, the abnormal left atrial feeding vessel suggested an embolic phenomenon from a cardiac tumor.

This case is an unusual presentation of an embolizing left atrial myxoma presenting as acute myocardial infarction in a young woman. This highlights the importance of including left atrial myxoma in the differential diagnosis of acute coronary syndrome in young female patients.