SHM Converge Scientific Abstract ePoster Gallery-Left Atrial Myxoma Presenting as Multiple Embolic Strokes: A Multidisciplinary Challenge

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This case report describes a 53-year-old woman with hypertension, hyperlipidemia, diabetes, and tobacco use who presented with left-sided weakness and was found to have a right middle cerebral artery stroke with multiple infarcts. She was outside the time window for thrombolysis or thrombectomy. Further evaluation with transthoracic echocardiography revealed a large, mobile left atrial mass, most consistent with an atrial myxoma, though thrombus was also considered. The mass was causing functional mitral stenosis, moderate pulmonary hypertension, and a trivial pericardial effusion.<br /><br />The report highlights atrial myxomas as the most common primary cardiac tumors and emphasizes that they often arise in the left atrium and may present with nonspecific symptoms or embolic events such as stroke. Echocardiography is the key diagnostic tool because it can assess the tumor’s size, mobility, and hemodynamic consequences. In this patient, the mass likely contributed both to systemic embolization and obstruction of mitral inflow.<br /><br />Management of atrial myxoma is usually surgical resection, but this case was complicated by the recent stroke, which made anticoagulation and operative timing difficult. The authors stress the importance of multidisciplinary collaboration among internal medicine, cardiology, and other specialties to balance the risks of further embolization against the risks of intervention after neurologic injury.<br /><br />Overall, the case illustrates the diagnostic and therapeutic challenges of left atrial myxoma presenting as multiple embolic strokes and reinforces the need for prompt echocardiographic evaluation and coordinated care.

Asset Subtitle

Malik Alqawasmi

Meta Tag

Author List Anthony Sandoval, Keenan Amer, Malik Alqawasmi

Category Clinical Vignettes

Concept Atrial Myxoma

Concept Echocardiography

Concept Surgical Resection

Concept Embolism

Concept Embolization

Distinguished Non-Finalist

Presenter Organization University of New Mexico

Presenting Author Malik Alqawasmi

Track Adult

Keywords

atrial myxoma

left atrial mass

embolic stroke

right middle cerebral artery stroke

echocardiography

functional mitral stenosis

pulmonary hypertension

cardiac tumor

systemic embolization

multidisciplinary care

Atrial Myxoma

Echocardiography

Surgical Resection

Embolism

Embolization