Case description
A 67-year-old female with a history of diabetes and hypertension was
admitted to the coronary care unit due to dyspnea associated with
dizziness, intermittent holocranial headache (Verbal Pain Intensity
Scale 3/10), cough, and stabbing chest pain that had begun three years
prior. Dyspnea had evolved from grade I to IV on the New York Heart
Association (NYHA) Scale in a one month period, after which she
consulted her physician, who referred her to the cardiologist after
ordering an anteroposterior chest-x ray that showed left cardiomegaly.
An apex beat was found on the 5th left intercostal space with a split
second sound secondary to a tumor plop. Follow-up transthoracic
echocardiogram (TTE) was performed, showing a mobile, regular edged 59 x
49 mm LA mass with a thin peduncle attachment to the atrial septum, that
protruded towards the left ventricle during diastole. An
electrocardiogram was performed, showing sinus rhythm with a slight left
axis deviation. (Figure 1) Subsequent Transesophageal
Echocardiography (TEE) was performed, observing a mass in the LA.(Figure 2) Surgical removal of the mass was performed
successfully, and the patient recovered fully after a few days.
Histopathologic analysis showed characteristic mucoid degeneration with
stellate cells (Figure 3) , thus confirming the diagnosis of a
left atrial myxoma that correlated in shape and size to the mass
observed through transillumination echocardiography (Figure 4) .
Follow-up TTE showed the absence of the mass with an adequately
functioning mitral valve and left ventricle.