Cutaneous embolic phenomena can be a presenting sign of atrial myxoma, requiring a high index of suspicion and urgent echocardiography to prevent serious complications.
Cutaneous emboli warrant urgent echocardiography to exclude myxoma; this case report leaves open prospective validation of screening protocols.
Cardiac myxoma often presents with heterogeneous symptoms and signs and represents a challenging diagnosis. The cutaneous manifestations, if present, are often transient and non-specific and the clinician must possess a high degree of suspicion to secure the diagnosis. We present the case of a 36-year-old woman with a 6-month history of intermittent, painful, violaceous, non-blanching macules on the thumb and fingertips of the left hand and right ankle. A cutaneous embolic phenomenon was suspected and an urgent echocardiogram demonstrated an atrial mass, with subsequent histopathology confirming the clinical suspicion of atrial myxoma. Early diagnosis and excision of the tumour avoided serious complications.
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Bandera et al. (2015) studied this question.
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