Atrial myxomas are heart tumours that are usually found in the left atrium.
It is very rare; the incidence is less than 0.14% (< 5 in 10,000). However, atrial myxoma is the most common of all primary cardiac tumours.
Peak incidence is in the 30-60 year age group with higher rates seen in females than in males. Some familial patterns of atrial myxoma have been seen.
The tumour grows slowly and eventually may close the mitral valve and thus may cause pulmonary hypertension and right heart failure from back pressure. The tumour may also become infected or become a source of thrombi (clots) which then embolise, potentially causing a stroke or heart attack.
Atrial myxomas are usually associated with constitutional symptoms of dyspnoea, syncope, fever and weight loss.
Depending on the location and size of the tumour, acute heart failure symptoms may be seen, such as dyspnoea, orthopnoea, paroxysmal nocturnal dyspnoea, cough, palpitations and chest pain.
Symptoms of embolic disease such as myocardial infarction or a stroke may dominate the presentation of the tumour.
Blood tests will frequently show mild anaemia and a raised ESR. A chest x-ray may show pulmonary congestion and possibly hypertrophy/dilatation of the left atrium.
Although atrial myxomas have the potential to embolise and to grow elsewhere, they are not believed to be able to spread to other sites. Surgical resection is usually curative and the main mortality and morbidity carried by these tumours is associated with complications such as embolisation - strokes or heart attacks.
Surgical excision is the treatement of choice and is usually curative.
Schlant RC, Alexander RW, Fuster V (eds). Hurst's The Heart (8th edition). New York, NY: McGraw-Hill; 1994. [Book]Kumar P, Clark M (eds). Clinical Medicine (4th edition). Edinburgh: WB Saunders Company; 1998. [Book]
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