* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download left atrial myxoma presenting as paroxysmal atrial fibrillation
Survey
Document related concepts
Coronary artery disease wikipedia , lookup
Cardiac contractility modulation wikipedia , lookup
Electrocardiography wikipedia , lookup
Myocardial infarction wikipedia , lookup
Rheumatic fever wikipedia , lookup
Cardiothoracic surgery wikipedia , lookup
Artificial heart valve wikipedia , lookup
Quantium Medical Cardiac Output wikipedia , lookup
Aortic stenosis wikipedia , lookup
Arrhythmogenic right ventricular dysplasia wikipedia , lookup
Cardiac surgery wikipedia , lookup
Ventricular fibrillation wikipedia , lookup
Hypertrophic cardiomyopathy wikipedia , lookup
Dextro-Transposition of the great arteries wikipedia , lookup
Lutembacher's syndrome wikipedia , lookup
Transcript
1216 either Cat: Vavlular heart disease/Heart valve surgery - adult LEFT ATRIAL MYXOMA PRESENTING AS PAROXYSMAL ATRIAL FIBRILLATION M.A. Zulqarnain, A. Ali, M. Ali, M.K. Syed, M.T. Mujtaba Wake Forest Baptist Health, Winston Salem, North Carolina, USA Introduction: We present a case of large left atrial myxoma causing functional mitral stenosis with initial presentation of new onset atrial fibrillation. Case Presentation: 55 year old female with past medical history significant for hypertension and diabetes presented with generalized weakness, fatigue, lightheadedness, shortness of breath and palpitations for the past two weeks. In the ER, she was found to be in atrial fibrillation and subsequently converted to normal sinus rhythm. Physical examination revealed a diastolic flow sound in the apical region. Echocardiogram revealed a moderately dilated left atrium with a large (2.5 x 4.7) myxoma attached to the interatrial septum which was prolapsing into the left ventricular cavity with irregular borders creating a functional mitral stenosis with valve area estimated at 1.1. Surgical opinion was sought and patient underwent minimally invasive atrial myxoma resection through anterior minithoracotomy. The patient tolerated the procedure well and her symptoms resolved. She has been doing well since then. Discussion: Myxomas are the most common primary cardiac tumors and about 75% are in the left atrium. Initial suspicion for myxomas is reported to be as low as 5.7%. Systemic embolization is present in about 30% of patients and valvular obstruction can sometimes result in sudden cardiac death. Left ventricular failure caused by partial obstruction of the mitral valve orifice by the myxoma can also be observed. Myxomas might be initially misdiagnosed as mitral stenosis, but severe mitral stenosis, as seen in our patient has been described in only 14% of cases. A diastolic murmur on auscultation is found in 64-67% of cases while classical tumor plop sound is found in 15% of cases. Myxomas are benign and have excellent long term prognosis with low recurrence rate after surgical resection. Myxomas should be considered in the differential diagnosis in patients with suspected mitral valve disease.