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Incidental Finding of an Exceptionally Large Left Atrial Myxoma Presenting as an Acute Cardioembolic Stroke

Left atrial myxomas are rare tumors that arise in the left atrium of the heart. As they become larger, they tend to grow into the atrial lumen and disrupt cardiac hemodynamics. Commonly reported symptoms include dyspnea, orthopnea, cough, peripheral edema, and fatigue. On physical examination, a cha...

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Autores principales: Bedoya, Rebecca A, Smith, Trevor, Ma, Hoan, Goodner, Amy, Sreedhar, Jason
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8523365/
https://www.ncbi.nlm.nih.gov/pubmed/34692285
http://dx.doi.org/10.7759/cureus.18056
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author Bedoya, Rebecca A
Smith, Trevor
Ma, Hoan
Goodner, Amy
Sreedhar, Jason
author_facet Bedoya, Rebecca A
Smith, Trevor
Ma, Hoan
Goodner, Amy
Sreedhar, Jason
author_sort Bedoya, Rebecca A
collection PubMed
description Left atrial myxomas are rare tumors that arise in the left atrium of the heart. As they become larger, they tend to grow into the atrial lumen and disrupt cardiac hemodynamics. Commonly reported symptoms include dyspnea, orthopnea, cough, peripheral edema, and fatigue. On physical examination, a characteristic “tumor plop” may be heard in some patients early in diastole. Left atrial myxomas may cause emboli to be released into the systemic circulation, which can lead to acute cardiovascular events, including strokes. We present the case of a 43-year-old female with sudden-onset slurred speech, left facial droop, and left-sided hemiplegia. CT angiography of the brain revealed a right middle cerebral artery infarct, and the patient underwent emergent mechanical thrombectomy. Upon workup for secondary causes of stroke, echocardiogram revealed an incidental 8 cm left atrial myxoma. After stabilization in the ICU, the patient was taken to surgery and the tumor was successfully removed. Over the course of admission, the patient’s left-sided hemiplegia gradually improved, and she was eventually transferred to inpatient rehabilitation care. A multidisciplinary effort involving medicine teams, neurology, cardiology, cardiothoracic surgery, neuro-interventional radiology, pain management, and endocrinology was essential in reaching the diagnosis. This case highlights the importance of considering a primary cardiac tumor such as a left atrial myxoma in the differential diagnosis when evaluating for secondary causes of acute ischemic stroke.
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spelling pubmed-85233652021-10-22 Incidental Finding of an Exceptionally Large Left Atrial Myxoma Presenting as an Acute Cardioembolic Stroke Bedoya, Rebecca A Smith, Trevor Ma, Hoan Goodner, Amy Sreedhar, Jason Cureus Cardiac/Thoracic/Vascular Surgery Left atrial myxomas are rare tumors that arise in the left atrium of the heart. As they become larger, they tend to grow into the atrial lumen and disrupt cardiac hemodynamics. Commonly reported symptoms include dyspnea, orthopnea, cough, peripheral edema, and fatigue. On physical examination, a characteristic “tumor plop” may be heard in some patients early in diastole. Left atrial myxomas may cause emboli to be released into the systemic circulation, which can lead to acute cardiovascular events, including strokes. We present the case of a 43-year-old female with sudden-onset slurred speech, left facial droop, and left-sided hemiplegia. CT angiography of the brain revealed a right middle cerebral artery infarct, and the patient underwent emergent mechanical thrombectomy. Upon workup for secondary causes of stroke, echocardiogram revealed an incidental 8 cm left atrial myxoma. After stabilization in the ICU, the patient was taken to surgery and the tumor was successfully removed. Over the course of admission, the patient’s left-sided hemiplegia gradually improved, and she was eventually transferred to inpatient rehabilitation care. A multidisciplinary effort involving medicine teams, neurology, cardiology, cardiothoracic surgery, neuro-interventional radiology, pain management, and endocrinology was essential in reaching the diagnosis. This case highlights the importance of considering a primary cardiac tumor such as a left atrial myxoma in the differential diagnosis when evaluating for secondary causes of acute ischemic stroke. Cureus 2021-09-17 /pmc/articles/PMC8523365/ /pubmed/34692285 http://dx.doi.org/10.7759/cureus.18056 Text en Copyright © 2021, Bedoya et al. https://creativecommons.org/licenses/by/3.0/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.
spellingShingle Cardiac/Thoracic/Vascular Surgery
Bedoya, Rebecca A
Smith, Trevor
Ma, Hoan
Goodner, Amy
Sreedhar, Jason
Incidental Finding of an Exceptionally Large Left Atrial Myxoma Presenting as an Acute Cardioembolic Stroke
title Incidental Finding of an Exceptionally Large Left Atrial Myxoma Presenting as an Acute Cardioembolic Stroke
title_full Incidental Finding of an Exceptionally Large Left Atrial Myxoma Presenting as an Acute Cardioembolic Stroke
title_fullStr Incidental Finding of an Exceptionally Large Left Atrial Myxoma Presenting as an Acute Cardioembolic Stroke
title_full_unstemmed Incidental Finding of an Exceptionally Large Left Atrial Myxoma Presenting as an Acute Cardioembolic Stroke
title_short Incidental Finding of an Exceptionally Large Left Atrial Myxoma Presenting as an Acute Cardioembolic Stroke
title_sort incidental finding of an exceptionally large left atrial myxoma presenting as an acute cardioembolic stroke
topic Cardiac/Thoracic/Vascular Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8523365/
https://www.ncbi.nlm.nih.gov/pubmed/34692285
http://dx.doi.org/10.7759/cureus.18056
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