SHM Converge Scientific Abstract ePoster Gallery-Dyspnea and Leg Swelling - A Rare Cause for a Common Problem: Left Atrial Myxoma Leading to Congestive Heart Failure

Dyspnea and Leg Swelling - A Rare Cause for a Common Problem: Left Atrial Myxoma Leading to Congestive Heart Failure

Pdf Summary

An 88-year-old woman with hypertension and hyperlipidemia presented after a fall, which she attributed to worsening leg swelling and progressive dyspnea on exertion over three weeks. Initial workup showed elevated high-sensitivity troponin and BNP, but no ischemic ECG changes. Chest X-ray revealed small bilateral pleural effusions, and lower-extremity Doppler ultrasound was negative for DVT. She was admitted for presumed volume overload and possible new heart failure, and her edema and dyspnea improved with IV furosemide.<br /><br />Echocardiography then revealed preserved left ventricular ejection fraction (55–60%) and a large 6 x 3 cm mass in the left atrium, with features consistent with a cardiac myxoma. The case highlights that atrial myxomas, though rare, can present with common heart failure symptoms due to obstruction of blood flow, and may also cause embolic or constitutional symptoms.<br /><br />Cardiac myxomas are the most common primary cardiac tumor and are usually benign. About 75% arise in the left atrium, often from the fossa ovalis. Left atrial myxomas can obstruct the mitral valve, causing dyspnea, edema, syncope, or even sudden cardiac death. They also carry a risk of systemic embolization.<br /><br />Cardiothoracic surgery was consulted, but operative mortality was estimated to be high given the patient’s age and comorbidities. After goals-of-care discussions, she declined surgery and chose palliative management. She was discharged on oral anticoagulation to reduce embolic risk and furosemide for symptom control.

Asset Subtitle

Jeanne Ho

Meta Tag

Author List Adrian P. Umpierrez, Jeanne Ho, TaRessa Wills

Category Clinical Vignettes

Concept Intracardiac Mass

Concept Atrial Myxoma

Concept Surgical Resection

Concept Echocardiography

Concept Left Atrial Mass

Distinguished Non-Finalist

Presenter Organization Emory University School of Medicine

Presenting Author Jeanne Ho

Track Adult

Keywords

cardiac myxoma

left atrial mass

heart failure symptoms

dyspnea on exertion

leg swelling

preserved ejection fraction

pleural effusions

systemic embolization

echocardiography

palliative management

Intracardiac Mass

Atrial Myxoma

Surgical Resection

Echocardiography

Left Atrial Mass