Spontaneous implantation of a left atrial myxoma into the left ventricle (RCD code: VI‑1A.1)

Abstract

Myxomas are one of the most common cardiac tumors. In 70–80% of cases they are located in the left atrium, 10–20% in the right atrium and in less than 10% in ventricles. We report a case of a 60-year-old patient after myocardial infarction of the posterior-inferior-lateral wall and subsequent percutaneous coronary interventions, who presented with symptoms of unstable angina. Based on standard criteria including cardiac enzymes acute coronary syndrome was excluded. Transthoracic echocardiogram showed hypokinesis of the lateral wall, normal left ventricular ejection fraction of 56%, left ventricular hypertrophy, enlarged heart chambers and moderate mitral regurgitation. Additional two masses were visualized -  one of 3.1 x 1.4 cm size growing from interatrial septum in the area of fossa ovalis in the left atrium, second of 1.2 x 0.4 cm connected to the chordae tendinae in the left ventricle. On transthoracic echocardiography a distal part of the left atrial structure spontaneously fell into the left ventricle hitting the tendinae. Successful surgical removal of both masses followed by pathological evaluation confirmed the diagnosis of myxomas.