Key result
Urgent concurrent open heart surgery and embolectomy successfully treated a 38-year-old man with acute upper extremity ischemia due to a massive left atrial myxoma, with no recurrence at 1 year.
Case Report (n=1)
No
This case highlights that embolic myxoma should be included in the differential diagnosis for young, otherwise healthy patients presenting with acute arterial ischemia.
Embolic myxoma may warrant consideration in the differential for acute arterial ischemia in young adults; this single case leaves open generalizability.
Atrial myxoma is the most common benign tumor of the heart. Patients who have atrial myxoma usually present with cardiac obstruction, arrhythmia, or peripheral embolization. We encountered an unusual case of acute upper extremity ischemia due to a massive atrial myxoma in a young man. A 38-year-old man was admitted to our hospital with an acute onset of severe, right upper extremity pain and paralysis while working. Neurologic examination yielded normal results, but the patient showed no palpable right radial or ulnar artery. Routine sonographic evaluation revealed acute aortic embolism in his right brachial artery. Because of his young age and otherwise healthy condition, we decided to perform transthoracic echocardiography, which showed a huge left atrial tumor, which we suspected to be myxoma. We then performed urgent concurrent open heart surgery and embolectomy to avoid further embolism. The microscopic findings of the resected tumor and embolism specimens were myxoma. He was discharged without complications.
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Chiba et al. (2012) conducted a case report in Left atrial myxoma with acute upper extremity embolism (n=1). Urgent concurrent open heart surgery and embolectomy was evaluated on Clinical outcome. Urgent concurrent open heart surgery and embolectomy successfully treated a 38-year-old man with acute upper extremity ischemia due to a massive left atrial myxoma, with no recurrence at 1 year.
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