Huseyın Goksuluk1, Orhan Veli Doğan2, Barbaros Dokumacı2 and Ilker Ozer2
1Ankara University, Cardiology Department, Ankara, Turkey
2Eskişehir Special Sakarya Hospital, Cardiology Department, Eskişehir, Turkey
Received: 07 June, 2016; Accepted: 27 June, 2016; Published: 29 June, 2016
Huseyın Goksuluk, Talatpaşa street, Ankara Üniversitesi İbni Sina Hospital, Sıhhiye, 6100, Ankara, Turkey, Tel: +90 312 - 508 25 27; Fax: 0903123125251; E-mail:
Goksuluk H, Doğan OV, Dokumacı B, Ozer I (2016) An Atypical Giant Right Atrial Myxoma Presented with Minimal Symptoms. Int J Vasc Surg Med. 2(1): 015-017. DOI: 10.17352/2455-5452.000013
© 2016 Goksuluk H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Atrial myxoma; Right atrial mass; Constitutional symptoms
Myxomas are the most common primary cardiac tumors, rarely found in the right atrium. Myxomas usually seen in women, typically between the ages of 40 and 60. We present a case of giant right atrial myxoma that prolapsing through the tricuspid valve into the right ventricle, in a 37-year-old man with constitutional symptoms. There was a discrepancy between atrial mass and intensity of symptoms. Our patient underwent surgical treatment with excision.
Primary tumours of the heart are not common and the prevalence of cardiac tumors ranges from 0,001% to 0,3% at autopsy . Over 70% of primary cardiac tumors are benign and the most common form of these primary tumours are myxomas. Most of the myxomas are located in the left atrium (%75–80), arising from the interatrial septum at the border of the fossa ovalis . Larger tumors are more likely to be associated with cardiovascular symptoms . Commonly observed symptoms and signs are dyspnea, pulmonary edema, cough, peripheral edema and fatigue. Constitutional symptoms (fever, weight loss) are seen in around 30% of patients. Laboratory abnormalities (anemia and elevations in the erythrocyte sedimentation rate, C-reactive protein) are present in 35 % of patients .
This case report show us discrepancy between giant right atrial myxoma and atypical symptom of patient. Once a cardiac myxoma is diagnosed, surgical excision should be performed without delays because of the risk of thromboembolic events [5-7], syncope and sudden cardiac death. Generally, surgical treatment is definitive and recurrence is uncommon.
We report a 37-year old male who came to hospital with cough, malaise, fewer and fatigue. There was no history of chest pain, palpitations, syncope, hypertension, diabetes mellitus, alcohol intake, cigarette smoking. Vital signs were stable with a blood pressure of 115/75 mmHg, pulse rate of 98 bpm and temperature of 37.0 °C. On the cardiovascular physical exam, there was a grade 2/6 holosystolic murmur at the left parasternal region. Pulses were normal in lower extremities with no edema. On the laboratory findings; the haemoglobin was 9,3 g/dl, hct 28 %. An elevated CRP level (24 mg/l) and erythrocyte sedimentation rate (ESR: 53) were reported in his blood test; otherwise, blood tests were normal. An electrocardiogram showed sinus rhythm. He had normal cardiac size with clear lung fields on chest X-ray. Transthoracic echocardiography (TTE) showed mild-moderate tricuspit regurgitation and a large echo-dense mass in the right atrium, attached to lateral free wall, filling the whole atrial chamber with prolapsing through the tricuspid valve into the right ventricle during diastole (Figure 1 and Movie Clip).