ECHOCARDIOGRAPHY PLAYS KEY ROLE IN ESTABILISHING THE

DIAGNOSIS OF CARDIAC MYXOMAS

A CASE REPORT OF ATRIAL MYXOMA

Bayu Anggara Hatami, MD

General practitioner at BLUD RSUD KOTA Banjar, Indonesia

BACKGROUND

The prevalence of primary cardiac tumors in United States is approximately

0.02%. about 75% of primary tumors are benign, and 50 % of benign tumors

are myxomas. Approximately 90% myxomas are solitary and peduculated.

The most common site of attachment is at the border of the fossa ovalis in the

left atrium Because of non specific symptomps, early diagnosis may be a

challenge, left atrial myxoma may or may not produce characteristic findings

on auscultation. Two- dimensional echocardiography is the diagnostic

procedur of choice. Most atrial myxomas can be removed by surgical

resection

Case presentation

A 41 years old male came to emergency department with chief complaint

progressive dyspnea on exertion for the last one week. He had also

intermittent chest pain and fatique. Chest pain was substernal, dull aching

type, 5/10 in intensity and non radiating.

Vital sign were stable with blood pressure of 120/70 mmhg. Pulse rate 100x .

bpm, respiratory rate 16 breath per minute and temperature 36.7. on

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Physical examination, Conjungtiva anemis (+), pupils were equal, reactive to

light. JVP was normal. Lungs were clear to auscultation bilaterally with no

wheezing or rhonchii. Cardiovascular exam was notable for grade 3/6

holosystolic murmur at apex and regular ryhtm. Abdomen was soft, non

tender, non distended with normal bowel sounds in all four quadrants. No

pitting edema in upper and lower extremities

Laboratory finding
Hb 10 g/dl
Leukosit 12.7 ribu/mm3
Trombosit 516 ribu/m m3
Hct 33 %
Ureum 21 mg/dl
Creatinine 1.0 mg/dl
Glucose 93 mg/dl
EKG

Ekg showed sinus takikardia 100 bpm and P mi

ECHO

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Echo showed LA dilated (4.1 diameter) and mass 12 cm2 with attachment to

the atrial septum. There is also a diastolic protrusion with obstruction

towards left long axis apical view during diastole.

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DISCUSSION

The patient presented with nonspecific chest pain symptomps. Common

symptomps and sign of exertional dyspnea and fatique lead to wide

dfferential diagnoses, making it critical for clinicians to be consider atrial

myxomas

Echocardiography plays key role in estabilishing the diagnosis of patients

with cardiac myxomas.

REFERENCE

1. Obrenovic-kirchanski B, Mikic A, Parapid B, et al. a 30 year single

center experience in atrial myxomas : from presentation to treatment

and prognosis. Thorax Cardiovasc Surg. 2013 Sep. 61 (6) :530-6

2. Ha JW, Kang WC, Chung N. Echocardiographic and morphologic

characteristics of left atrial myxoma and their relation to systemic

embolism. Am J Cardiol. 1999. 83 ; 1579-1582.

3. Zheng JJ, Geng XG, Wang HC, Yan Y, Wang HY. Clinical and

Histopathological analysis of 66 cases with cardiac myxoma. Asian pac

J Cancer Prev. 2013. 14(3) :1743-6

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4.