What is the clinical evidence from this study?

Study design: Observational. Population: Cardiac myxoma (n=67). Intervention: Cardiac myxoma. Primary outcome: Incidence of asymptomatic cardiac myxoma.

March 31, 2020Open Access

Clinical presentation of cardiac myxoma in a Singapore national cardiac centre

PLPT LeeNational Yang Ming Chiao Tung University RHRachel HongUniversity of Toronto PPPY PangNational Heart Centre Singapore

Key Result

Among 67 surgically resected cardiac myxomas, 28.4% were asymptomatic, with an increasing trend of incidental detection from 19.4% in 2000-2008 to 36.1% in 2009-2016.

Study Design

Type

Observational (n=67)

Multicenter

Structured PICO

What is the clinical presentation and incidence of asymptomatic cardiac myxoma in patients undergoing surgical resection?

Population

67 consecutive cases of surgically resected cardiac myxoma in 66 patients (mean age 53.1 years, 73.1% female) treated at a single national cardiac center over a 17-year period.

Exposure

Surgical resection of cardiac myxoma

Outcome

Clinical presentation (symptomatic vs asymptomatic)

The diagnosis of asymptomatic cardiac myxoma is increasing over time, likely driven by greater use of opportunistic screening and medical imaging.

Limitations

Single-centre study, meaning results may not be generalisable to all other centres.
Retrospective observational study design with inherent bias in data collection.
Potential underestimation of recurrence rates due to some patients being lost to follow-up.

Abstract

INTRODUCTION: Cardiac myxoma is the most common cardiac tumour. In this study, we summarise our 17-year experience with the clinical presentation of cardiac myxoma at National Heart Centre Singapore, Singapore. METHODS: Between January 2000 and December 2016, retrospective data was reviewed for all consecutive patients who underwent surgical resection of cardiac myxoma. Patients' clinical characteristics were reviewed and described. RESULTS: A total of 67 (18 male, 49 female; mean age 53.1 ± 13.5 years) patients underwent cardiac myxoma resection. There were 19 (28.4%) patients with asymptomatic cardiac myxoma. There were no significant differences in gender; body habitus and myxoma size; and haemoglobin, white blood cell or platelet counts between patients with symptomatic and asymptomatic myxoma. However, the number of asymptomatic cardiac myxomas seemed to follow an increasing trend from 19.4% (period 2000-2008) to 36.1% (period 2009-2016), suggestive of an 'era effect'. CONCLUSION: In our study, a majority of patients were women, with a wide age range of 18-78 years. The diagnosis of asymptomatic cardiac myxoma was present in 28.4% of patients, with an increasing trend for incidence over the years. This is possibly due to increased opportunistic screening (with electrocardiography and clinical examination) as well as higher usage of medical imaging.

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