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Definition

What is an atrial myxoma?

An atrial myxoma is a type of benign tumor of the heart, most commonly found within the left and then to the right atria on the interatrial septum. Atrial myxomas are the most common primary heart tumors. Because of nonspecific symptoms, early diagnosis may be a challenge. Left atrial myxoma may or may not produce characteristic findings on auscultation. Two-dimensional echocardiography is the diagnostic procedure of choice. Most atrial myxomas are benign and can be removed by surgical resection.

How common are atrial myxomas?

Based upon the data of 22 large autopsy series, the prevalence of primary cardiac tumors is approximately 0.02% (200 tumors per million autopsies). About 75% of primary tumors are benign, and 50% of benign tumors are myxomas, resulting in 75 cases of myxoma per million autopsies.

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of an atrial myxoma?

Some signs and symptoms of atrial myxomas may occur at any time, but most often they accompany a change of body position. Pedunculated myxomas can have a “wrecking ball effect”, as they lead to stasis and may eventually embolize themselves. Symptoms may include:

  • Shortness of breath with activity
  • Platypnea – Difficulty breathing in the upright position with relief in the supine position
  • Paroxysmal nocturnal dyspnea – Breathing difficulty when asleep
  • Dizziness
  • Fainting
  • Palpitations – Sensation of feeling your heart beat
  • Chest pain or tightness
  • Sudden death (In which case the disease is an autopsy finding)

The symptoms and signs of left atrial myxomas often mimic mitral stenosis. General symptoms may also be present, such as:

  • Cough
  • Pulmonary edema, as blood backs up into the pulmonary artery, after increased pressures in the left atrium and atrial dilation
  • Hemoptysis
  • Fever

These general symptoms may also mimic those of infective endocarditis.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consulting with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes an atrial myxoma?

Most cases of atrial myxoma are sporadic, and the exact etiology is still unknown. Familial atrial myxomas have an autosomal dominant transmission.

Some experts believe that Carney syndrome is genetically heterogenous and is caused by a defect in more than one gene. It is estimated to account for 7% of all atrial myxomas without any predilection for age or sex. Abnormalities in the short arm of chromosome 2 (Carney) and chromosome 12 (Ki-ras oncogene) have been described. In one case report, a frame-shift mutation was found in exon 2 in the causative gene of Carney complex, protein kinase A regulatory subunit 1 alpha. At present, there does not appear to be an association between cardiac myxomas and herpes simplex types 1 and 2.

Risk factors

What increases my risk for an atrial myxoma?

You may have higher risks for this condition if you are experiencing these following conditions:

Age

In case, you are between the ages over 50, you may have a higher risk of developing this condition than do other age groups.

Sex

The condition is more common in women.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is an atrial myxoma diagnosed?

If your doctor suspects that you may experience this condition, a physical examination will be performed and some tests will be also recommended by your doctor. Your doctor will listen to the heart with stethoscope. A “tumor plop” (a sound related to movement of the tumor), abnormal heart sounds, or a murmur similar to the mid-diastolic rumble of mitral stenosis may be heard. These sounds may change when the patient changes position.

Some recommended tests may include:

  • Echocardiogram and Doppler study
  • Chest x-ray
  • CT scan of chest
  • Heart MRI
  • Left heart angiography
  • Right heart angiography
  • ECG—may show atrial fibrillation

How is an atrial myxoma treated?

No known medical treatment exists for atrial myxoma. Drug therapy is used only for complications such as congestive heart failure or cardiac arrhythmias. The only one treatment option of atrial myxomas is surgery. The tumor must be surgically removed. Some patients will also need their mitral valve replaced. This can be done during the same surgery. It is noticed that myxomas may come back if surgery did not remove all of the tumor cells. Minithoracotomy with robotically assisted surgery has been reported, resulting in a shorter length of hospital stay, and it is considered a safe and feasible method for atrial myxoma excision. The investigators did not observe any difference in the quality of life between the two strategies. A case report of total endoscopic robotic resection of a left atrial myxoma in an elderly patient with persistent left superior vena cava also demonstrated good outcome.

Noticeably, in case myxoma is suspected, a cardiologist should be consulted and a cardiothoracic surgical consultation will be required for consideration of resection.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage an atrial myxoma?

Unfortunately, there is no prevention for this condition.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 8, 2017 | Last Modified: August 8, 2017

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