A rare cause of syncope: left atrium myxoma in a diabetic hypertensive patient

Introduction: Myxomas are the most common primary tumors of the heart and usually are located in the left atrium. Symptoms are nonspecific and early diagnosis may be a challenge. Most of them are benign and are removed by surgical resection.

Case presentation: A 67 years old female, known with hypertension and diabetes mellitus, was admitted with episodes of syncope during the weeks before admission. She was evaluated clinically, 12 lead ECG, chest X-ray, cerebral computer tomography (CT) scan, tran-sthoracic (TTE) and transesophageal (TEE) echocardiography, laboratory investigations, 24 hours Holter monitoring and coronary angiography, At clinical examination tumor plop was heard after the second heart sound. ECG revealed sinus rhythm and no arrhythmia was detected on Holter monitoring. 2D TTE revealed a large mass in the left atrium which pro-truded truth mitral valve during diastole and a small pericardial effusion. No gradient was found at PW Doppler mitral inflow evaluation. Color Doppler revealed a mild mitral regurgitation. TEE was performed to find the place of attachment, the relation with mitral valve and pulmonary veins and for differentiation the myxoma from vegetation or thrombus. This mass was attached by a pedicle to the basal portion of the intra-atrial septum. The cerebral CT scan excluded neurolo-gical complications. Chest x-ray and angiography were in a normal range. Surgical intervention was taken into consideration and the mass was completely resected. Evolution after the surgical intervention was good.

Conclusions: This presentation reveals a favorable evolution of a patient with a myxoma located in the left atrium. Echocardiography, especially transesophageal echocardiography is the tool of choice for diagnosis. Early surgical resection is important in preventing complications.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
ESC search engine
CODE: 379
CME Credits: 10 (Romanian College of Physicians)
This work is licensed under a Creative Commons Attribution 4.0 International License.