Cystic and hemorrhagic giant left atrial myxoma in a patient presenting with exertional angina and dyspnea.

Myxomas are the most common type of primary cardiac tumors and are usually localized in the atrium. The clinical features of the disease depend on the size, location, mobility, and fragility of the mass. In our case report, we present a 38-year-old female patient admitted to our hospital with typical exertional angina and dyspnea. Diagnosis of giant cystic/hemorrhagic atrial myxoma was established after imaging modalities including echocardiography, angiography, and radiology and the pathological evaluation of the mass. On the coronary angiography, a significant feeding artery of the tumor originating from the right coronary artery and the cystic/hemorrhagic appearance all raised the suspicion for the presence of other cardiac masses. However, the pathological evaluation of the mass was reported as consistent with myxoma, with many prominent cystic and hemorrhagic fields and no evidence of malignancy. Since large intratumoral hemorrhagic fields and the presence of a significant feeding artery secondary to tumor neovascularization were observed, we hypothesized that the remarkable amount of blood flow from the coronary artery to the giant myxoma may result in a kind of coronary steal phenomenon and typical anginal symptoms of the patient.

Coronary embolism causing non-ST elevation myocardial infarction in a patient with paroxysmal atrial fibrillation: treatment with thrombus aspiration catheter.

Coronary embolism is an uncommon cause of acute coronary syndromes and there is no standard recommended therapeutic algorithm for this rare entity. Herein, we present a 69-year-old female patient diagnosed with non-ST elevation myocardial infarction due to coronary embolism secondary to paroxysmal atrial fibrillation. Considering the clinical characteristics of the patient and also no evidence of atherosclerotic basis for the lesion on the coronary angiogram, thrombus aspiration was decided to be the optimal treatment for this case. She underwent a successful thrombus aspiration procedure and followed by long-term oral anticoagulant therapy with warfarin.

Coronary saddle embolism causing myocardial infarction in a patient with mechanical mitral valve prosthesis: treatment with thrombolytic therapy.

Coronary embolism is an uncommon cause for myocardial infarction in clinical practice and there is no consensus on the treatment of this subject. Thrombolytic agents and percutaneous intervention are up to date options and yet there are only a few case reports regarding thrombolytic therapy in this special subgroup of patients suffering from myocardial infarction. We reported a 37-year-old woman patient with non-ST elevation myocardial infarction due to coronary embolism who was successfully treated using intravenous thrombolytic therapy with tissue plasminogen activator.