Cardiac Myxoma Clinical Presentation and Its Anaesthetic Management; A Systemic Review.

Cardiac myxomas are the most common primary tumours of the heart. Although they are benign, they are considered "functionally malignant" due to their high potential for embolisation. These tumours primarily originate in the left atrium, specifically from the limbus of the fossa ovalis in the interatrial septum, but they can occur in any chamber of the heart. While most cardiac myxomas are sporadic, some cases are familial and associated with the Carney complex. Morphologically, they can be either pedunculated or sessile. Clinically, they present with a triad of symptoms: intracardiac obstruction, systemic embolisation, and constitutional symptoms. Echocardiography is the preferred diagnostic tool for assessing cardiac myxomas. Genetic testing can identify mutations in the PRKAR1A gene in familial cases of the condition. Surgical excision is the treatment of choice, and the prognosis after cardiac myxoma resection surgery is excellent, with a very low rate of recurrence. Despite their benign nature, cardiac myxomas pose significant challenges for anesthesiologists due to their variable presentation. This review summarizes the diverse clinical presentations of cardiac myxomas, their implications, the anesthetic challenges they present, and strategies for anesthetic management.