Md. Faruque Uddin
Associate Professor, Dept. of Cardiology, NEMC, Sylhet
Abstract
Left atrial myxomas remain the most common benign primary cardiac tumors, and these cardiac growths can masquerade as mitral stenosis, infective endocarditis and collagen vascular disease. Atrial myxomas are found in approximately 14-20% of the population and can lead to embolization, intercardiac obstructions, conduction disturbances and lethal valve obstructions.
An 80-year-old woman presented with complaints of dizziness upon standing and palpitation, and with no prior history of heart murmurs, syncope, shortness of breath, or chest pain. Physical examination revealed evidence of orthostatic hypotension and a soft grade 1/6 systolic murmur at the left sternal border. A transthoracic echocardiogram revealed a large atrial myxoma occupying the majority of the left atrium attached to the inter atrial septum.
This patient did not present with the common symptoms associated with an atrial myxoma, which amy include chest pain, dyspnea, orthopnea, peripheral embolism or syncope. Two-dimenslional echocardiography provides substantial advantages in detecting intracardiae tumors. We recommend a two-dimensional echocardiogram in the workup of orthostatics hypotension of unknown etiology after the common causes such as autonomic disorders, dehydration, and vasodilative dysfunctions had been ruled out. By illustrating this correlation between orthostasis and an atrial myxoma, we hope to facilitate earlier identification of these intracardiac growths.