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CASE REPORT
Diffuse cerebral embolism as the first manifestation of the right atrial myxoma
1
Clinical Department of Internal Medicine, Gastroenterology and Hepatology with the Unit of Cardiology and the Centre for Heart Failure Treatment and Cardio-Oncology, University Clinical Hospital in Olsztyn, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Poland
2
Department of Cardiac Surgery, Provincial Specialist Hospital in Olsztyn, Poland
3
Clinical Department of Neurology, University Clinical Hospital in Olsztyn, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Poland
4
Department of Cardiology, Provincial Specialist Hospital in Olsztyn, Poland
5
Department of Internal Medicine and Cardiology, Medical University of Warsaw, Poland
Submission date: 2015-03-01
Acceptance date: 2015-05-04
Online publication date: 2015-07-07
Publication date: 2020-03-26
Corresponding author
Leszek Gromadziński
Clinical Department of Internal Medicine, Gastroenterology and Hepatology with the Unit of Cardiology and the Centre for Heart Failure Treatment and Cardio-Oncology, University Clinical Hospital in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland. Tel.: +48 89 524 53 89; fax: +48 89 524 53 89.
Clinical Department of Internal Medicine, Gastroenterology and Hepatology with the Unit of Cardiology and the Centre for Heart Failure Treatment and Cardio-Oncology, University Clinical Hospital in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland. Tel.: +48 89 524 53 89; fax: +48 89 524 53 89.
Pol. Ann. Med. 2015;22(2):136-138
KEYWORDS
ABSTRACT
Introduction:
Neurological complications in patients with diagnosed atrial myxoma occur in approximately 30% of cases.
Aim:
The aim of this paper is to present the case of a female patient with right atrial myxoma and demonstrate neurological complications.
Case study:
This paper presents the case of a 51-year-old female patient who was admitted to the hospital due to dizziness, nausea, vomiting and gait disorders lasting for two days. Head computed tomography (CT) showed vascular changes in the cerebellum and magnetic resonance imaging (MRI) of the brain revealed numerous synchronous, recent vascular diffuse foci in the left occipital lobe and left cerebellar hemisphere. Transthoracic echocardiography examination (TTE) detected the myxoma in the right atrium with the suspicion of atrial septal defect secundum (ASD2). The patient underwent a successful surgery to remove the right atrial myxoma. The procedure also revealed ASD2.
Results and discussion:
Myxoma is one of the most common primary heart tumors and it accounts for about 50% of benign heart tumors; three out of four cases involve women. Most myxomas are localized in the left atrium and only approximately 18% are found in the right one. The symptoms of brain damage usually appear when the tumor is localized in the left atrium and rarely occur when the tumor involves the right atrium. In the presented case, during the procedure, the coexistence of ASD2, which may lead to crossed embolism, was confirmed.
Conclusions:
The right atrial myxoma may manifest with neurological symptoms due to diffuse cerebral embolism.
Neurological complications in patients with diagnosed atrial myxoma occur in approximately 30% of cases.
Aim:
The aim of this paper is to present the case of a female patient with right atrial myxoma and demonstrate neurological complications.
Case study:
This paper presents the case of a 51-year-old female patient who was admitted to the hospital due to dizziness, nausea, vomiting and gait disorders lasting for two days. Head computed tomography (CT) showed vascular changes in the cerebellum and magnetic resonance imaging (MRI) of the brain revealed numerous synchronous, recent vascular diffuse foci in the left occipital lobe and left cerebellar hemisphere. Transthoracic echocardiography examination (TTE) detected the myxoma in the right atrium with the suspicion of atrial septal defect secundum (ASD2). The patient underwent a successful surgery to remove the right atrial myxoma. The procedure also revealed ASD2.
Results and discussion:
Myxoma is one of the most common primary heart tumors and it accounts for about 50% of benign heart tumors; three out of four cases involve women. Most myxomas are localized in the left atrium and only approximately 18% are found in the right one. The symptoms of brain damage usually appear when the tumor is localized in the left atrium and rarely occur when the tumor involves the right atrium. In the presented case, during the procedure, the coexistence of ASD2, which may lead to crossed embolism, was confirmed.
Conclusions:
The right atrial myxoma may manifest with neurological symptoms due to diffuse cerebral embolism.
CONFLICT OF INTEREST
None declared.
REFERENCES (9)
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Rafajlovski S, Ilić R, Gligić B, et al. Diagnosis and results of treatment of heart myxoma. Vojnosanit Pregl. 2011;68(10):851–855.
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Rydlewska-Sadowska W. Clinical Echocardiography. Warszawa: Biblioteka Instytutu Kardiologii; 1991:295 [in Polish].
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