A Rare Cause of Pulmonary Hypertension and Right Ventricular Failure: Left Atrial Myxoma.

• Type of Material: Article
• Authors: Arielle Schwartz, J. Willis Hurst Internal Medicine Residency Program, Atlanta, Georgia.; Evan Blank, Emory University Division of Cardiology, Atlanta, Georgia.; Marc Thames, Emory University
• Language: English
• Date: 2021-04
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2020 by the American Society of Echocardiography. Published by Elsevier Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.case.2020.11.005
• Title of Journal or Parent Work: CASE (Phila)
• Volume: 5
• Issue: 2
• Start Page: 90
• End Page: 92
• Keywords: Pulmonary hypertension; TTE; Myxoma
• Research Categories: Health Sciences, Education; Biology, Physiology

Abstract

Primary cardiac tumors are rare, with an estimated incidence of 0.1%. Atrial myxomas make up about 50% of these tumors. Patients may present with a variety of symptoms, which are related to obstruction of circulation, embolization, interference with cardiac valves, and/or direct invasion of the myocardium or adjacent lung tissue.1 The first recorded attempt at diagnosing a left atrial tumor in a living person occurred in 1951 using an unsuccessful surgical technique following identification of an enlarged left atrium on angiography.2 It wasn't until the early 1970s that the first two-dimensional echocardiogram was used clinically, allowing for visualization and characterization of myxomas.3 As technology has evolved, diagnostic accuracy and safety of excising such tumors have improved. Here we describe a rare case of a left atrial myxoma with obstruction of mitral flow and the integral role that transthoracic echocardiography (TTE) played in identifying the mass and quantifying the secondary pulmonary hypertension and right ventricular (RV) failure that resulted from its obstructive physiology.