Left atrial myxoma: an unusual cause of pre-syncope and symptomatic bradycardia

Figures

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  Fig. 1. Electrocardiogram. a pre-operative electrocardiogram showing sinus bradycardia with a heart rate of 39 without ischemic changes. b post-operative electrocardiogram showing resolution of bradycardia with a heart rate of 69

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  Fig. 2. Transthoracic Echocardiogram During Systole and Diastole. a Left atrial myxoma attached to interatrial septum measuring approximately 3 cm × 4.8 cm. b Independently moving myxoma shown obstructing the mitral valve orifice during diastole. LA left atrium; LV left ventricle; RA right atrium; RV right ventricle

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  Fig. 3. Myxoma as a Heterogeneous Hyperechoic Mass with Definity Enhanced Imaging. a Echocardiographic image showing (3 cm × 4.8 cm) heterogeneous hyperechoic mass in left atrium attached to the interatrial septum by a stalk (arrow). b Definity enhanced ultrasound of left atrial myxoma demonstrating heterogeneous echogenicity within the mass representative of vascularity

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  Fig. 4. Resected Myxoma. Gross pathological specimen of myxoma that was resected with an estimated size of 5.5 × 5.1 × 3 cm, next to visual estimation of size

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  Fig. 5. Doppler Flow and Calculated Mean Pressure Gradient Across Mitral Valve. a Doppler Image of Myxoma showing flow around the myxoma. b Mean pressure gradient across mitral valve measured in apical four chamber with Velocity Time Integral method, revealing Mean Pressure Gradient of 1.31 mmHg

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  Fig. 6. Coronary Angiography with Tumor Blushing. Angiography of RCA showing perfusing vessels to the left atrial myxoma with tumor blushing. RCA right coronary artery