Atrial myxoma Information & Atrial myxoma Links at HealthHaven.com

Atrial myxoma
	Classification and external resources
	; Micrograph of an atrial myxoma. H&E stain.

An atrial myxoma is a non-cancerous tumor in the upper left or right side of the heart. It grows on the wall (atrial septum) that separates the two sides of the heart.

[edit] Causes

Myxomas are the most common type of heart tumor.^[1] They are far more common than metastatic tumors of the heart.

The tumor is derived from multipotential mesenchymal cells and may cause a ball valve-type obstruction.

About 75% of myxomas occur in the left atrium of the heart, usually beginning in the wall that divides the two upper chambers of the heart. The rest are in the right atrium. Right atrial myxomas are sometimes associated with tricuspid stenosis and atrial fibrillation.

Myxomas are more common in women. About 10% of myxomas are passed down through families (inherited). Such tumors are called familial myxomas. They tend to occur in more than one part of the heart at a time, and often cause symptoms at a younger age than other myxomas.

[edit] Symptoms

Symptoms may occur at any time, but most often they accompany a change of body position. Symptoms may include:

Shortness of breath with activity
Breathing difficulty when lying flat
Breathing difficulty when asleep
Dizziness
Fainting
Sensation of feeling your heart beat (palpitations)
Chest pain or tightness

The symptoms and signs of left atrial myxomas often mimic mitral stenosis. General symptoms may also be present, such as:

Cough
Fever
Involuntary weight loss
General discomfort (malaise)
Joint pain
Blueness of skin, especially the fingers (Raynaud's phenomenon)
Fingers that change color upon pressure or with cold or stress
Curvature of nails accompanied with soft tissue enlargement (clubbing) of the fingers
Swelling - any part of the body

These general symptoms may also mimic those of infective endocarditis.

[edit] Diagnosis

The health care provider will listen to the heart with stethoscope. A "tumor plop" (a sound related to movement of the tumor), abnormal heart sounds, or murmur may be heard. These sounds may change when the patient changes position.

Right atrial myxomas rarely produce symptoms until they have grown to be at least 13 cm (about 5 inches) wide.

Tests may include:

Echocardiogram
Doppler study
Chest x-ray
CT scan of chest
Heart MRI
Left heart angiography
Right heart angiography
ECG -- may show atrial fibrillation

Blood tests: A CBC may show anemia and increased WBCs (white blood cells). The erythrocyte sedimentation rate (ESR) is increased.

[edit] Treatment

The tumor must be surgically removed. Some patients will also need their mitral valve replaced. This can be done during the same surgery.

Myxomas may come back if surgery did not remove all of the tumor cells.

[edit] Prognosis

Although a myxoma is not cancer, complications are common. Untreated, a myxoma can lead to an embolism (tumor cells breaking off and traveling with the bloodstream), which can block blood flow or cause the myxoma to grow in another part of the body. Myxoma fragments can move to the brain, eye, or limbs.

If the tumor grows inside the heart, it can block blood flow through the mitral valve and cause symptoms of mitral stenosis. This may require emergency surgery to prevent sudden death.

[edit] Complications

Arrhythmias
Pulmonary edema
Peripheral emboli
Spread (metastasis) of the tumor
Blockage of the mitral heart valve
Stroke
Fusiform cerebral aneurysms

[edit] Additional images

Atrial myxoma and myocardium. H&E stain.

Atrial myxoma. H&E stain.

Atrial myxoma covered by endothelium. H&E stain.

[edit] See also

Papillary fibroelastoma

[edit] References

^ Vaideeswar, P.; Butany, JW. (Feb 2008). "Benign cardiac tumors of the pluripotent mesenchyme.". Semin Diagn Pathol 25 (1): 20-8. PMID 18350919.

[pmid18350919-0] Vaideeswar, P.; Butany, JW. (Feb 2008). "Benign cardiac tumors of the pluripotent mesenchyme.". Semin Diagn Pathol 25 (1): 20-8. PMID 18350919.

[1]

Contents