Left atrial myxoma simulating peripheral vasculitis

Left atrial myxoma remains a diagnostic challenge clinically. A brief review of previously reported cases and their individualistic clinical and laboratory features are described. The present case report documents an unusual clinical presentation, initially directing attention to the central nervous system as well as to the peripheral arterial system. Histologic evidence of peripheral arterial myxomatous emboli, associated with vasculitis but without other confirmatory immunologic evidence of collagen vascular disease, had predated for 14 months the subsequent echocardiographic diagnosis of left artrial myxoma. These findings further emphasize the importance of recognizing the enigmatic and variable clinical presentation of left atrial myxoma.