Systemic manifestations of atrial myxoma

Background: Approximately 70% of the cardiac tumors are benign, atrial myxoma is the most common, and is seen more in females. Presentation is variable, and patients can present with cardiac symptoms or systemic manifestations. Prognosis may be grave if the presentation is late or if the diagnosis and surgery is delayed. Accurate diagnosis, early surgical intervention gives excellent results.Methods: The study was conducted in the department of cardiovascular and thoracic surgery, all the patients who had diagnosis of cardiac myxoma irrespective of age, sex and associated diseases were included in the study. Transthoracic echocardiography was the initial investigation of choice, in some vascular Doppler studies, and CT scan was also done. All were operated under cardiopulmonary bypass, myxoma was approached by left atriotomy, tumor along with its base was excised, and the defect so created was closed directly or a patch repair was done.Results: Majority were in 5th decade of life, females were more. Presentation included breathlessness, edema, hemiparesis, monoparesis, aphasia. Clinical examination revealed anemia, dyspnea, edema, audible murmur, weakness of limb/limbs and aphasia. Echocardiography established diagnosis in all. Left atrium was the common chamber involved. Interatrial septum on left atrial side was the common site of myxoma origin. All had uneventful post-operative period, and there was no mortality.Conclusions: Atrial myxoma, though very rare, can present with a grim phenomenon, early and accurate diagnosis, followed by excision under cardiopulmonary bypass gives excellent results.