 |
This article does not cite any references or sources. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (November 2006) |
| 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.
Contents |
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.
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.
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.
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.
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.
Complications
- Arrhythmias
- Pulmonary edema
- Peripheral emboli
- Spread (metastasis) of the tumor
- Blockage of the mitral heart valve
- Stroke
- Fusiform cerebral aneurysms
Additional images
 Atrial myxoma and myocardium. H&E stain. |
 Atrial myxoma. H&E stain. |
 Atrial myxoma. H&E stain. |
 Atrial myxoma covered by endothelium. H&E stain. |
See also
References
|
||||||||||||||
This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)
