What Is Atrial Myxoma?

Atrial myxoma is the most common primary cardiac tumor, accounting for approximately 50%. Patients are mostly between 30 and 50 years old. The incidence is slightly higher in women than in men. A few patients have a family history.

Atrial myxoma

Atrial myxoma is the most common primary cardiac tumor, accounting for approximately 50%. Patients are mostly between 30 and 50 years old. The incidence is slightly higher in women than in men. A few patients have a family history.

Myxomas are mostly single lesions, and very few cases present two or more tumors in the same or different cardiac cavities.

nickname

Atrial myxoma

Multiple groups

30 to 50 years old

Common locations

heart

Common symptoms

Atrioventricular valve blood flow obstruction causes palpitations and shortness of breath

Small myxomas can be asymptomatic. After the tumor grows up, there are three types of symptoms including hemodynamic changes of the whole body and peripheral vascular embolism. The most common clinical symptoms of left atrial myxoma are palpitations and shortness of breath caused by obstructed atrioventricular valve blood flow, which is similar to rheumatic mitral valve disease. On physical examination, diastolic or systolic murmurs can be heard in the apical region, and secondary sounds in the pulmonary valve region are enhanced. In patients with large tumor activity, when the patient changes the vein anger, the loudness and nature of the noise may change accordingly. Myocardial tumors of the right atrium can cause jugular venous distension, hepatomegaly, ascites, lower extremity edema and other symptoms similar to tricuspid valve stenosis or constrictive pericarditis when the tricuspid valve orifice is blocked. On physical examination, diastolic murmurs can be heard in the 4th and 5th intercostal space on the left margin of the sternum.

Large-moving myxomas, such as sudden obstruction of the atrioventricular valve orifice, can cause seizures, convulsions, and even sudden death.

Liquid tumor cases can still present with systemic manifestations such as recurrent fever, loss of appetite, weight loss, joint pain, anemia, etc., with increased red blood cell sedimentation rate and increased serum globulin. The cause of these symptoms is not clear, it may be the body's immune response to tumors. The earliest clinical manifestation of a small number of myxoma cases is peripheral arterial embolism, and the emboli are removed and confirmed by pathological examination.

X-ray examination of left atrial myxoma often shows enlargement of left atrium and right ventricle, pulmonary stasis and other signs of phase transition with mitral valve disease. Electrocardiogram performance is similar to mitral valve disease, but atrial fibrillation rarely occurs in myxoma cases. The clinical diagnosis of left atrial myxoma is easily confused with rheumatic mitral valve disease.

Most cases of myxoma have no history of rheumatic fever, and the course is short. Symptoms and signs may change with changes in body position. Electrocardiograms mostly show sinus rhythm. Echocardiographic examination can see the moving cloud-like echoes of myxoma. The left atrial myxoma is located in the atrial cavity during systole and is displaced to the mitral valve orifice during diastole. The diagnostic accuracy of echocardiography is extremely high.

Myxoma cases should be surgically removed as soon as possible after a clear diagnosis, to restore cardiac function, to avoid malignant changes in the tumor and sudden blockage of the atrioventricular valve, leading to sudden death, or tumor debris shedding and embolism.

Myxoma removal requires extracorporeal circulation. The atrial incision or left and right atrial incision is used to remove the tumor along with the part of the atrial septal tissue connected to its pedicle through the left atrial incision. During the surgery, care should be taken to avoid damaging the tumor tissue. After the tumor is removed, each heart cavity should be examined in detail, and the heart cavity should be repeatedly washed with physiological saline to prevent the leakage of multiple myxomas or residual tumor debris.

Myxoma has good surgical treatment, with low surgical mortality and recurrence rate.