The clinical syndrome of atrial myxoma

Seventeen cases of atrial myxoma were reviewed to delineate features that facilitate the correct diagnosis. Each patient had features of a classic triad of obstructive, constitutional, and embolic effects. Common findings included a short (two years or less) clinical course in 10, no rheumatic fever in 16, syncope or paroxysmal dizziness in 9, systemic emboli with sinus rhythm in 3, and symptoms of systemic illness in 10. On auscultation, left atrial myxoma mimicked rheumatic mitral valve disease, but discriminating clues were variable auscultatory findings in five patients and an accentuated S, or apparent opening snap with notable mitral regurgitation in four. Features of systemic illness, anemia, or leukocytosis in ten patients and a high sedimentation rate or elevated immunoglobulin level in eight suggested myxoma. Angiography confirmed the preoperative diagnosis. As long as 15 years since surgery, there have been no recurrences following definitive tumor resection at our hospital. (JAMA230:695-701, 1974)