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Left atrial myxoma and cardioembolic stroke in a young patient: a case report and literature review

https://doi.org/10.18705/1607-419X-2021-27-5-572-582

Abstract

Myxoma of the heart is the most common variant of a primary benign heart tumor, which is complicated in some cases by embolic complications. Myxoma of the heart is often a diagnostic puzzle in young patients due to a low-symptom or masked clinical manifestations. This case report presents a 37-year-old patient with the onset of left atrial myxoma with mitral valve obstruction manifested with syncope, associated traumatic brain injury, rightsided hemihypesthesia, and speech difficulties. The examination showed multiple lacunar ischemic brain lesions in the middle cerebral artery basin. Transthoracic echocardiography (TTE) showed a large left atrial myxoma with prolapse into the left ventricle. Myxoma was successfully removed. The case highlights the complexity of the diagnosis of cardiac myxoma, associated with the variable clinical manifestations from low-symptomatic cases to the development of cardioembolic complications. Considering recurrent embolic complications, a quick identification of the causes of ischemic stroke in patients without cardiovascular risk factors is important. TTE is a highly specific and sensitive method for the diagnosis of cardiac myxoma. Surgery is a priority treatment method, characterized by a good prognosis for sporadic single-chamber isolated myxomas.

About the Authors

О. Yu. Korennova
Omsk State Medical University; City clinical cardiology dispensary
Russian Federation

Olga Yu. Korennova — MD, PhD, DSc, Professor, Professor of the Department of Internal Diseases and Family Medicine; Acting Chief Physician

9 Lenina street, Omsk, 644009



I. V. Druk
Omsk State Medical University
Russian Federation

Inna V. Druk — MD, PhD, DSc, Assistant Professor, Head, Department of Internal Diseases and Family Medicine

9 Lenina street, Omsk, 644009



S. N. Starinskaya
City clinical cardiology dispensary
Russian Federation

Snezhanna N. Starinskaya — MD, Head, Department of Functional Diagnostics

Omsk



J. V. Tereshchenko
Omsk State Medical University
Russian Federation

Julia V. Tereshchenko — MD, PhD, Assistant Professor, Department of Internal Diseases and Family Medicine

9 Lenina street, Omsk, 644009



Yu. T. Ignatiev
Omsk State Medical University
Russian Federation

Yuri T. Ignatiev — MD, PhD, DSc, Professor, Professor of the Department of Radiation Diagnostics

9 Lenina street, Omsk, 644009



R. A. Delov
Omsk State Medical University

Roman A. Delov — MD, PhD, Associate Professor, Department of Neurology and Neurosurgery with the Course of Advanced Medical Training

9 Lenina street, Omsk, 644009



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Korennova О.Yu., Druk I.V., Starinskaya S.N., Tereshchenko J.V., Ignatiev Yu.T., Delov R.A. Left atrial myxoma and cardioembolic stroke in a young patient: a case report and literature review. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2021;27(5):572-582. (In Russ.) https://doi.org/10.18705/1607-419X-2021-27-5-572-582

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ISSN 1607-419X (Print)
ISSN 2411-8524 (Online)