SHM Converge Scientific Abstract ePoster Gallery-Atrial Myxoma: Rare Differential for Shortness of Breath

Pdf Summary

This case describes a 49-year-old man with OSA, Parkinson’s disease, hyperlipidemia, and obesity who presented with three weeks of progressive exertional dyspnea and exertional abdominal/chest/neck/jaw pain relieved by rest. He denied infectious or volume overload symptoms, but exam showed tachycardia, JVD, and trace leg edema. Labs were largely normal except for a markedly elevated BNP. CTA ruled out pulmonary embolism but showed pulmonary artery dilation, mild pulmonary edema, and small pleural effusions.<br /><br />Echocardiography revealed reduced ejection fraction, pulmonary hypertension, mild valvular regurgitation, left atrial enlargement, and a large left atrial mass. Further workup with cardiac catheterization showed two-vessel coronary artery disease and moderate mitral stenosis, while cardiac MRI confirmed an atrial mass arising from the interatrial septum and severe LV dysfunction with an EF of 21%.<br /><br />The patient underwent CABG and surgical resection of the mass. Pathology confirmed the tumor was a cardiac myxoma, the most common primary cardiac tumor but still rare. The discussion emphasizes that myxomas can cause nonspecific cardiopulmonary symptoms such as dyspnea and edema, often mistaken for heart failure. In this patient, symptoms and reduced EF were due to a combination of severe CAD and the atrial myxoma.<br /><br />The report also reviews proposed mechanisms linking myxomas with coronary disease, including embolization of thrombotic material and inflammatory cytokine effects such as IL-6–mediated prothrombotic and negative inotropic activity. The patient was discharged three days after surgery with plans for follow-up echocardiography in six months to assess recovery of cardiac function.

Asset Subtitle

Martha C. Lopez Siles

Meta Tag

Author List Alexis L. Cammarata, Jenna Laughlin, Martha C. Lopez Siles

Category Clinical Vignettes

Concept Atrial Myxoma

Concept Echocardiography

Concept Surgical Resection

Concept Exertional Dyspnea

Concept Heart Failure

Distinguished Non-Finalist

Presenter Organization Christiana Care

Presenting Author Martha C. Lopez Siles

Track Adult

Keywords

cardiac myxoma

heart failure

coronary artery disease

dyspnea

pulmonary hypertension

left atrial mass

mitral stenosis

CABG

ejection fraction

interatrial septum

Atrial Myxoma

Echocardiography

Surgical Resection

Exertional Dyspnea

Heart Failure