Common Type Of Benign Primary Cardiac Tumor

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TERMINOLOGY CLINICAL CLARIFICATION • The most common type of benign primary cardiac tumor, which can cause valvular or inflow-outflow tract obstruction and thromboembolism; symptoms appear when the tumor fragments and causes systemic emboli or when it interferes with cardiac valvular function and causes pulmonary congestion 1 • Most atrial myxomas arise from the atrial septum, but some originate in the posterior wall, anterior wall or the appendages 1 CLASSIFICATION • By location 3, 1, 2 ○ Left atrial myxoma - 75-90% of myxomas are estimated to originate in the left atrium 1, 2, 3 ○ Right atrial myxoma - tends to be more solid and immobile than left atrial myxoma, with a wider attachment to the septum or atrial wall 1 • Atrial myxomas can…show more content…
t-sided heart failure (also seen in advanced stages of heart failure related to left atrial myxoma) 1 – Fatigue is the most common systemic symptom 4 ○ Symptoms related to embolization 1 – Vision loss is possible with involvement of retinal arteries – Signs of transient ischemic attack, stroke or seizure, which may result from central nervous system embolization – Signs of pulmonary embolism and infarction in right-side embolization ○ Constitutional symptoms - observed in 30-50% of cases 5, 1 – Fever and weight loss are seen in about 30% of patients 5 – Arthralgias, malaise and cough are also common – Severe dizziness or syncope occur in 20% of patients, usually due to obstruction of mitral valve in patients with left atrial myxomas 1 – Hemoptysis due to pulmonary edema or infarction is seen in up to 15% of patients 1 – Angina pectoris is seen infrequently; when present, it may be due to coronary embolization • Physical examination ○ General physical exam can reveal 1 – Cyanosis – Rash or petechiae – Digital clubbing – Raynaud’s phenomenon – Signs characteristic of Carney syndrome (spotty pigmentation of the skin, myxomas in breast, skin, thyroid gland or neural tissue) – Peripheral edema (can be a sign of right-sided heart failure) – Abdominal distension due to ascites (rare; more common in slowly-growing right sided tumors) ○ Cardiovascular exam 5, 1 – Jugular venous pressure may be elevated; a prominent A-wave may be present – An early diastolic sound, called a "tumor
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