Clinical Experience of Cardiac Myxoma

ABSTRACT

BACKGROUND AND OBJECTIVES: Cardiac myxoma is histologically benign, but may be lethal because of their strategic position. It may mimic every cardiovascular or systemic disease, and can be missed without a high idex of suspicion. MATERIALS AND METHOD: We reviewed our clinical experience in 25 patients with cardiac myxoma between 1984 and 1999. Special attention was paid to clinical presentation, physical examination, chest X-ray, electrocardiogram, laboratory findings, echocardiographic findings, operative findings and postoperative course. RESULTS: Their age ranged from 23 to 64 (mean 48 years) and there were 6 male (24%) and 19 (76%) female patients. The myxomas were located in the left atrium in 23 (88%), in the right atrium in 2 (12%) cases. The Major presenting symptoms were intracardiac obstruction such as exertional dyspnea in 19 (76%), palpitation in 7 (28%), syncopal episodes in 3 (12%) cases while systemic embolism and constitutional symptoms accounted for 5 (20%) and 10 (40%) cases, respectively. About 70% of patients were present with abnormal, but nonspecific findings in physical examination, chest X-ray, electrocardiogram, and laboratory findings. Echocardiography is the most useful diagnostic screening tool. There was no in-hospital death after operation. But only 1 patient died 5 years after resection from severe pulmonary hypertension and right ventricular failure and 1 patient presented with recurrence at 18 months after primary resection, which was confirmed histologically into chondrosarcoma. CONCLUSION: We conclude that due to nonspecific presentation of cardiac myxoma, a high index of suspicion is needed. If considered as a possible diagnosis, it is easily recognized by echocardiography and usually curative by surgical resection.