Left atrial myxoma: a report of two cases and literature review

Abstract

Case I

Myxomas are the commonest primary cardiac tumours, and were initially described in 1845 by King TW.^2-1 Myxomas are tumours of endocardial origin that usually project into the cardiac chambers from the endocardial surface. The clinical presentation is highly variable, ranging from asymptomatic to life threatening complications of atrioventricular valve obstruction or embolic phenomena. Non specific symptoms such as fevers, sweats, arthralgias, loss of weight etc have also been described. These symptoms represent the triad of obstructive, embolic and constitutional symptoms.^1-3 There have been a number of case reports from Africa, demonstrating this variation in clinical presentation.^4-8 To the best of our knowledge, there are no reported cases of atrial myxomas from Zimbabwe. We describe here, two cases of left atrial myxoma with different clinical presentations and outcomes.

Case II

A 68 year old female patient presented to the Echocardiography clinic for echocardiographic examination of the heart. She had been complaining of shortness of breath on exertion for the past five months. The degree of exercise limitation had been gradually worsening and over the preceding two months, she had been experiencing shortness of breath on minimal exertion. She denied any history of orthopnea, but admitted to experiencing paroxysmal nocturnal dyspnoea. She had also been experiencing a nocturnal cough since eight months before this presentation. She denied any history of wheezing. She had been experiencing episodes of palpitations, which she described as a very strong impulse which was not very fast and was regular. The episodes of palpitations were associated with the shortness of breath. She had no history of syncope or pre-syncope.  She experienced no fever, chills or sweats. Her appetite was normal and she denied any significant weight loss.