From Silent to Life-Threatening: Giant Left Atrial Myxoma Presenting with Acute Pulmonary Edema—A Case Report

Background and Clinical Significance: Cardiac myxomas, though typically benign and asymptomatic, can rarely present with acute cardiovascular compromise. We report a case of a left atrial myxoma presenting as acute pulmonary edema in a patient with prior normal cardiac imaging. Case Presentation: A 55-year-old male, with a history of thrombolyzed myocardial infarction and normal coronary angiography and echocardiography five years earlier, was admitted with acute dyspnea and pulmonary edema. Bedside transthoracic echocardiography (TTE) revealed a left atrial mass causing severe mitral inflow obstruction. Emergency surgical excision was performed, and the mass was submitted for histopathological analysis. Discussion: Histology confirmed cardiac myxoma. The procedure and recovery were uneventful, and follow-up at one month confirmed no recurrence. Conclusions: This case illustrates the potential for cardiac myxoma to manifest suddenly with life-threatening symptoms, even after previously normal investigations. Echocardiography remains pivotal in diagnosing intracardiac masses and guiding timely intervention.