In cases of nonfatal arterial emboli with normal cardiac evaluation, an aggressive angiographic and surgical search may be necessary to identify and treat a primary cardiac myxoma to prevent future fatal embolization.
May prompt advanced imaging in unexplained emboli with normal initial evaluation; leaves open whether aggressive surgical search improves outcomes.
Right internal carotid and left brachial arterial occlusions resulting from left atrial myxoma occurred in the absence of cardiac findings to explain the embolization. Following surgical removal of the myxomatous emboli, a cardiac source was suspected, and therefore, cardiac surgery was performed. A small, irregular tumor base was found in the left atrium, but no morphologic heart abnormalities were present. When nonfatal arterial emboli occur, even in the presence of a normal cardiac evaluation, an aggressive angiographic and surgical search for the cause may prevent future fatal embolization due to primary cardiac myxoma. (JAMA228:864-865, 1974)
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J. R. Thompson (1974) studied this question.
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