Why the study?
Atrial myxomas are rare, clinically diverse tumors whose diagnosis is often prolonged with risk of irreversible damage or death, highlighting the need to emphasize echocardiography and a high index of suspicion.
Highlights the importance of bedside echocardiography in the rapid diagnosis of atrial myxoma presenting as systemic embolization to prevent irreversible damage.
Alerts to myxoma in young males with limb ischemia; case report leaves open need for prospective diagnostic studies.
Myxomas are very rare intracardiac benign tumors. They can arise in any of the cardiac chambers, although 75% occur in the left atrium. Atrial myxomas (AMs) show a female predominance with a sex ratio of 3:1. There is a diversity in the clinical presentation; it may resemble many cardiovascular or systemic diseases. Furthermore, it is possible to present as an acute upper or lower limb ischemia or organ infarction due to systemic emboli. Hereby, we report a previously healthy 38-year-old male, who presented to the emergency department with acute pain of both lower limbs, unilateral upper limb, and acute abdomen. A bedside transthoracic echocardiogram was done which showed a mass that was confirmed to be an AM. The patient underwent surgical embolectomy and tumor resection. As this tumor is rare, the duration between the onset of symptoms to finally reaching the correct diagnosis is usually prolonged, and meanwhile, the patient can experience irreversible neurological damage or even death. Hence, we would like to highlight the role of echocardiogram in detecting AMs. In addition, excluding the primary cause of the thrombi, the patient’s ischemic pain has a spectrum of differential diagnosis ranging from peripheral vascular disease to COVID-19. We would also like to emphasize the importance of a high index of suspicion by emergency physicians when such cases present.
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Younes et al. (2022) studied this question.
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