A 46-year-old male presenting with acute ischemic stroke was diagnosed with a left atrial myxoma using 3D TEE, which was successfully resected with intra-operative 3D TEE guidance.
Case Report (n=1)
Left atrial myxomas are rare primary cardiac tumors. Their incidence is estimated to be about 0.1% of total cases. Neurological complications resulting from cardiac myxomas are seen in 20-35% of patients. Transesophageal echocardiogram (TEE) is preferred over transthoracic echocardiogram for evaluation of left atrial myxoma. Three-dimensional (3D) echocardiography ensures better visualization of intracardiac structures. It has been used prior to surgery for diagnostic support in the surgical treatment of cardiac masses. We present a case of a 46-year-old Hispanic male who developed acute ischemic stroke of left frontal lobe and was also found to have multiple 'silent' cerebral infarcts in the MRI of the brain. On further workup, he was found to have a left atrial myxoma on 3D TEE. This was resected with the assistance of intra-operative 3D TEE imaging. We present this case to increase awareness and to stress at early evaluation of secondary causes of ischemic cerebrovascular accident, outside the realm of hypercoagulability. This case also exhibits the need for basic cardiac workup in young individuals who present with symptoms of intermittent palpitations or chest pain to minimize significant morbidity or mortality.
Iyer et al. (Fri,) conducted a case report in Left atrial myxoma (n=1). Surgical resection with intra-operative 3D TEE imaging was evaluated. A 46-year-old male presenting with acute ischemic stroke was diagnosed with a left atrial myxoma using 3D TEE, which was successfully resected with intra-operative 3D TEE guidance.