Left atrial myxoma should be considered in the differential diagnosis of patients presenting with symptoms and laboratory findings compatible with systemic vasculitis, even in the absence of a heart murmur.
May support considering myxoma in unexplained vasculitis-like illness without murmur; leaves open prospective validation.
Left atrial myxoma has often stimulated systemic vasculitis or a connective tissue disease, but the diagnosis is usually suggested by cardiac symptoms or signs. The present case report is both unusual and instructive in that the patient presented with a painless left foot drop followed by digital vasculitis. Laboratory findings included depressed total hemolytic complement and elevated anti-double-stranded DNA. Despite frequent and careful observation, a heart murmur was not appreciated. Because of the unusual features and the patient's frequent military travels, the diagnosis of left atrial myxoma was not established for 8 months. This case history stresses the importance of considering the possibility of atrial myxoma in patients with heart murmurs whose symptoms, physical findings, and laboratory studies could be compatible with a systemic vasculitis.
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Byrd et al. (1980) studied this question.
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