A Voluminous Left Atrial Myxoma in a 62-Year Old Man With Atrial Fibrillation: A Case Report and Review of the Literature

The incidence of primary tumors of the heart varies between 0.0017 and 0.19 percent in unselected patients at autopsy.Three of four tumors are benign and nearly half the benign heart tumors are myxomas. We present a case report of a 62-year-old caucasian man without known cardiovascular risk factors presented at the emergency room (ER) for palpitations. The initial EKG showed rapid atrial fibrillation around 100 bpm and the patient complained of a recent dyspnea at exertion. Cardiac ultrasound was performed to rule out valvular or ischemic disease and measure the size of the left atrium. It showed a voluminous mass of 6 cm x 5 cm in the left atrium. The surgical removal of the tumor was indicated and a CT scan of the coronary arteries was performed in this 62-year-old patient that showed mild stenosis on the LAD. The patient was sent to cardiac surgery. This case suggests that prompt surgical treatment was safe with a low operative mortality and good long term prognosis. Cardiac ultrasound was the method of choice for diagnosis and follow-up. Contrast echocardiography allowed differentiating between cardiac tumors, myxomas and thrombi in most cases due to the difference in vascularisation.