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European Journal of Echocardiography 2005 6(2):144-145; doi:10.1016/j.euje.2004.08.004
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Copyright © 2005, The European Society of Cardiology

A giant left atrial myxoma prolapsing to midlevel of the left ventricle causing severe pulmonary hypertension

Ozcan Ozeke*, Omac Tufekcioglu, Hatice Selcuk, Ozgur Ulas Ozdogan and Onur Sahin

Yuksek Ihtisas Hospital, Department of Cardiology, Ankara, Turkey

Received 29 July 2004; accepted after revision 12 August 2004.

* Corresponding author. Tel.: +90 312 3632761. ozcanozeke{at}hotmail.com

Keywords: Left atrial myxoma; Pulmonary hypertension

We present a patient with a giant left atrial myxoma occupying most of the left atrial cavity and prolapsing to the midlevel of the left ventricle.

A previously healthy 52-year-old woman was referred to our hospital because of a murmur. She was in a normal state of health until approximately 6 months before admission, when she experienced mild fatigue. Her past medical and family history were unremarkable. Her blood pressure was 110/80mmHg in the supine position and 120/80mmHg when she was seated; heart rate was 85/bpm. Auscultation revealed a normal S1 and S2 and a diastolic rumble at the apex. Chest X-ray showed substantial enlargement of the main pulmonary artery. An electrocardiogram showed sinus tacyhcardia with incomplete right bundle branch block and left atrial hypertrophy. Echocardiography showed a large mobile mass attached to the inter-atrial septum occupying the most of the left atrial cavity and prolapsing into the left ventricle during diastole (Fig. 1). Apical 4-chamber view revealed enlargement of both the right atrium and right ventricle. The estimated pulmonary artery pressure by Doppler echocardiography was 85mmHg (Fig. 2). She underwent surgical resection of the left atrial mass. Histopathologic examination of the resected material confirmed the diagnosis of myxoma. The patient made an uneventful recovery and was discharged 1 week later.


Figure 1
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  		Figure 1 Two dimensional echocardiography in the parasternal long axis view shows a large mobile mass attached to the inter-atrial septum occupying the whole of the left atrium and prolapsing into the left ventricle during diastole. Ao, aort; LV, left ventricle; RV, right ventricle.

 


Figure 2
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  		Figure 2 Apical 4-chamber view shows enlargement of both right atrium and right ventricle and the estimated pulmonary artery pressure is 85mmHg with Doppler echocardiography. RA, right atrium; LV, left ventricle; RV, right ventricle.

 

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This Article
Right arrow Extract Freely available
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Right arrow Articles by Ozeke, O.
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