Key result
Emergency resection treats STEMI caused by left atrial myxoma embolization.
Why the study?
Left atrial myxomas can cause systemic embolic events including rare presentations as ST-elevation myocardial infarction due to coronary embolism.
Case Report (n=1)
This case report highlights a rare presentation of a left atrial myxoma manifesting as a STEMI due to tumor embolization, emphasizing the importance of echocardiography in identifying the cause and selecting the appropriate management strategy.
Background Cardiac myxomas are the most common primary tumours of the heart. Left atrial myxomas can present with systemic embolic manifestations. We describe a case of a left atrial myxoma that presented as ST-elevation myocardial infarction presumed to be caused by embolism to the left circumflex artery. Case summary A 52-year-old woman with no prior comorbidities presented with sudden-onset chest pain and dizziness. Electrocardiogram revealed ST-segment elevation in leads II,III, and aVF. Echocardiogram showed hypokinesia of the basal and mid inferior wall. Additionally, a large, mobile left atrial mass attached to the interatrial septum, prolapsing into the mitral inflow. The patient was transferred to the catheterisation laboratory for coronary angiogram. Angiogram showed an occluded distal obtuse marginal branch. There was no evidence of atherosclerosis in the rest of the coronary vasculature. Given high suspicion of embolic occlusion, the patient underwent emergency resection of the left atrial mass on day 3. The resected specimen was filled with gelatinous material and had a smooth surface.Histopathological examination confirmed diagnosis of myxoma. Discussion Our case illustrates a rare presentation of left atrial myxoma, with coronary artery occlusion highly suspected to have resulted from embolism of myxomatous material. A high index of suspicion and echocardiographic evaluation are needed to elucidate the cause of myocardial infarction, which would help select the appropriate reperfusion strategy.
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Narayanan et al. (2026) conducted a case report in ST-elevation myocardial infarction and left atrial myxoma (n=1). Emergency resection of the left atrial mass was evaluated. A 52-year-old woman presenting with ST-elevation myocardial infarction secondary to presumed left atrial myxoma embolization underwent emergency surgical resection of the mass on day 3.
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