What is the clinical evidence from this study?

Study design: Systematic Review. Population: Right atrial myxoma (n=619). Intervention: Right atrial myxoma. Primary outcome: Clinical manifestations and mortality.

September 12, 2024Open Access

Clinical and laboratory manifestations, ECG findings, and outcomes of right atrial myxoma: a systematic review of cases reported worldwide

Key Result

Right atrial myxoma most commonly presented with cardiac (77.0%), systemic (34.8%), and neurologic (21.1%) manifestations, and was associated with a low overall mortality rate of 9.2%.

Study Design

Type

Systematic Review (n=619)

Structured PICO

Population

619 patients with right atrial myxoma from 480 case reports and case series worldwide, with a mean age of 45.7 years and 55.4% female.

Outcome

Clinical and laboratory manifestations, ECG findings, and outcomes (mortality)

Right atrial myxoma is a rare cardiac tumor that most commonly presents with cardiac, systemic, and neurologic manifestations, and is associated with a low mortality rate of 9.2%.

Limitations

Only case reports and case series were included, introducing a potential risk of bias
Lack of data regarding some required information in most included studies
Publication bias should be considered as most included studies reported positive outcomes
Possibility of missing relevant studies due to limitations in the search strategy or databases used

Abstract

BACKGROUND: The presence of cardiac myxoma in the right atrium (RA) is rare. There is limited knowledge regarding the clinical symptoms and diagnosis of RA myxoma. This systematic review aimed to provide a summary of the clinical and laboratory characteristics, electrocardiogram (ECG) findings, and outcome previous cases with RA myxoma. METHODS: A comprehensive search was conducted in PubMed, Web of Science, and Scopus to identify relevant studies. Inclusion criteria were case reports and case series written in English that provided sufficient data on the manifestation of RA myxoma. Descriptive statistics were used for quantitative analysis. RESULTS: The search identified 619 patients from 480 eligible studies. The patient's mean age was 45.7 ± 17.6 years, and 55.4% of cases were female. The most common clinical manifestations of RA myxoma were cardiac, systemic, and neurologic manifestations which reported in 77.0%, 34.8%, and 21.1% of cases, respectively. Besides, 11.7% of RA myxoma were asymptomatic. ECG findings revealed normal in 39.4% reported cases. The ECG abnormalities included tall or peaked P-wave, RA and LA enlargement (19.2%), abnormal T-wave (14.0%), sinus tachycardia (11.8%), and incomplete or complete RBBB (11.2%). Echocardiography remained the diagnostic method in a majority of the cases. The mortality rate of RA myxoma was low (9.2%) during the follow-up. CONCLUSIONS: This systematic review provides a comprehensive summary of the clinical and laboratory manifestations and outcomes of RA myxoma, contributing to the existing knowledge on this rare cardiac tumor.

Bookmark

View Full Paper