Cardiac Myxomas. A Clinical Challenge!

Abstract

INTRODUCTION:

Primary cardiac tumours are rare, in review of 480,331 necropsies Strauss and Merliss found an incidence of only 0.17 per 1000 (1). Left atrial myxoma is the commonest primary tumour of the heart (2). Less frequently myxoma originates from the right atrium and only occasionally from the ventricles (3).

RESULTS:
The ages of six males and six females ranged from 24 to 52 years (mean=38 years). The commonest clinical presentation was dyspnoea (100%). Palpitation was the next common symptom (42%).

DISCUSSION:

Left atrial myxomas can mimic mitral stenosis and hence delay the diagnosis. This was the commonest diagnosis in our series and is comp arable with other series (8, 9, 10). The clinical features in atrial myxomas are obstructive, constitutional, and embolic (3). Obstructive effects are produced from the occlusion of mitral or tricuspid valve opening thus causing pulmonary hypertension and hence dyspnoea which was the common feature in all our cases. Pedunculated tumours produce mitral or tricuspid valve murmurs as a result of deformed mitral or tricuspid valve.ECG and chest X-ray are unhelpful by themselves. 2DE is the single most helpful test which must be performed in all cases of mitral stenosis and those suspected of atrial myxorna, i.e., unexplained embolism or unexplained constitutional symptoms for exclusion of atrial myxoma.