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European Journal of Echocardiography 2008 9(1):130-132; doi:10.1016/j.euje.2007.04.009
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org

Massive right atrial myxoma causing exertional dyspnoea

R.S. Bilku1,*, M. Loubani2, M. Been1 and R.L. Patel2

1 Department of Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK
2 Department of Cardiothoracic Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK

Received 23 March 2007; accepted after revision 15 April 2007; online publish-ahead-of-print 25 June 2007.

* Corresponding author. Tel: +44 2476964000; fax: +44 2476965657. E-mail address: rajbilku{at}hotmail.com


   Abstract

Metastatic tumours are the commonest cardiac tumours being found in 1–3% of patients dying of cancer while primary tumours are unusual and have an incidence of 0.02–0.5%. The majority (80%) of all primary cardiac tumours are benign with myxomas accounting for 50%. Myxomas arising from the right atrium are uncommon.

We present the case of a 39-year-old female with a 4-month history of progressive exertional dyspnoea accompanied by symptoms of palpitations and presyncope. Transthoracic echocardiography showed an extremely large right atrial myxoma prolapsing into the right ventricle and obstructing the tricuspid valve. We demonstrate how intraoperative transoesophageal echocardiography, prior to sternotomy, was useful in providing information about the myxoma which clearly displayed its attachment and anatomical relationship in the planning of the ‘safe’ surgical excision.

Keywords: Right atrial myxomas; Transoesophageal echocardiography; Transthoracic; Cardiac mass


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