A Rare Case of Atrial Myxoma Mimicking Right-Sided Heart Failure

Abstract

Background: Myxomas are rare, with an incidence of 0.0017% in the general population. The majority (75–80% of cases) of myxomas are located in the left atrium, and 18% of cases are located in the right atrium with diverse clinical manifestations. Presentation of Case: A 30-year-old woman presented with a chief complaint of dyspnea and near syncope on effort, and a history of ascites and bilateral lower extremity edema. Transthoracic echocardiography (TTE) disclosed a substantial mass in the RA, indicative of myxoma, causing right ventricular (RV) inflow obstruction with a mean gradient of 18 mmHg. The patient was undergoing urgent open-heart surgery with resection of an 8.5 x 6.5 cm multilobulated mass. The residual septal defect was rectified with direct closure. Tricuspid valve coaptation testing was satisfactory. The diagnosis of myxoma was validated through a histological examination. The post operative recovery was unremarkable, and the patient was discharged on the sixth day following surgery. Discussion and Conclusion: RA myxoma often goes undetected due to its low incidence rate and its character of mimicking right heart failure presentation. Postponement of surgical operation may result in irreversible consequences therefore surgical resection should be executed promptly following diagnosis.