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Left atrial myxoma presenting as a systemic vasculitis
Arthritis and Rheumatism
|February 1, 1980
Summary
Left atrial myxoma can mimic systemic vasculitis, presenting with unusual symptoms like foot drop. Early consideration of cardiac tumors is crucial for timely diagnosis, even without typical heart murmurs.
Area of Science:
- Cardiology
- Rheumatology
- Systemic Vasculitis
Background:
- Left atrial myxoma (LAM) is a cardiac tumor often associated with systemic vasculitis or connective tissue diseases.
- Diagnosis of LAM typically relies on cardiac symptoms or auscultation findings like heart murmurs.
Observation:
- A case report details a patient presenting with a painless left foot drop and subsequent digital vasculitis.
- Initial laboratory findings revealed depressed total hemolytic complement and elevated anti-double-stranded DNA antibodies.
- A heart murmur was not appreciated despite careful observation.
Findings:
- The patient's presentation mimicked systemic vasculitis, delaying LAM diagnosis for eight months.
- Unusual symptoms and frequent military travel complicated the diagnostic process.
- The case highlights the importance of considering LAM in atypical presentations.
Implications:
- This case underscores the necessity of including atrial myxoma in the differential diagnosis for patients presenting with vasculitic symptoms.
- It emphasizes that cardiac tumors can manifest with non-cardiac signs and subtle cardiac findings.
- Diagnostic vigilance for LAM is critical, especially when symptoms align with systemic inflammatory conditions.