Cardiac myxoma

A type of primary heart tumor

Cardiac Myxoma

A cardiac myxoma is a type of primary heart tumor that is typically benign. It is the most common type of primary cardiac tumor in adults, accounting for approximately 50% of all such tumors. Myxomas are usually found in the left atrium of the heart, although they can occur in other chambers as well.

Pathophysiology

Cardiac myxomas are gelatinous tumors that arise from the endocardium, the inner lining of the heart. They are composed of a myxoid stroma, which is a loose connective tissue, and are often attached to the endocardium by a stalk. The tumors can vary in size and may be pedunculated or sessile.

Clinical Presentation

Patients with cardiac myxoma may present with a variety of symptoms, which can be grouped into three categories: obstructive, embolic, and constitutional.

Obstructive Symptoms

Obstructive symptoms occur when the myxoma interferes with normal blood flow through the heart. This can lead to symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. In some cases, the tumor may cause syncope or even sudden cardiac death if it obstructs blood flow significantly.

Embolic Symptoms

Embolic symptoms occur when fragments of the tumor break off and travel through the bloodstream, potentially causing stroke or other embolic events. This is more common when the myxoma is located in the left atrium, as emboli can travel to the systemic circulation.

Constitutional Symptoms

Constitutional symptoms are systemic symptoms that may include fever, weight loss, and malaise. These symptoms are thought to be due to the release of cytokines by the tumor.

Diagnosis

The diagnosis of cardiac myxoma is typically made using echocardiography, which can visualize the tumor within the heart. Transesophageal echocardiography provides a more detailed view and is often used to confirm the diagnosis. Other imaging modalities, such as MRI or CT scan, may also be used.

Treatment

The primary treatment for cardiac myxoma is surgical resection. This involves removing the tumor and a portion of the surrounding endocardium to prevent recurrence. Surgery is usually curative, and the prognosis after resection is generally excellent.

Prognosis

The prognosis for patients with cardiac myxoma is generally good following surgical removal. Recurrence is rare but can occur, particularly if the tumor is not completely excised. Regular follow-up with echocardiography is recommended to monitor for recurrence.

Related Pages

• Heart disease
• Cardiac tumor
• Echocardiography
• Surgical oncology