J Cardiovasc Ultrasound.  2008 Jun;16(2):59-62. 10.4250/jcu.2008.16.2.59.

A Case of Large Left Atrial Myxoma Presenting as Atrial Flutter

• Lee JH
• Lee GW
• Kim OK
• Hur JH
• Choi BJ
• Choi KJ
• Cha TJ
• Lee JW
• Kim HS

• KMID: 1491043
• DOI: http://doi.org/10.4250/jcu.2008.16.2.59

Abstract

Cardiac myxoma is the most common benign cardiac tumor and it presents various clinical symptoms and signs. Although two-thirds of patients have abnormal electrocardiographic findings, atrial flutter or conduction abnormalities are known to be rare. We report on a case of a large left atrial myxoma which was diagnosed by trans-thoracic, trans-esophageal echocardiography, chest computerized tomography, and histological examination. The myxoma was presented as atrial flutter in a 41-year old man who was complaining palpitation and dyspnea on exertion. After surgical excision of the mass, atrial flutter converted to normal sinus rhythm. We report this case with review of literatures on left atrial myxoma associated with arrhythmia.

Keyword

Cardiac myxoma; Atrial flutter

MeSH Terms

Arrhythmias, Cardiac
Atrial Flutter
Dyspnea
Echocardiography
Electrocardiography
Heart Neoplasms
Humans
Myxoma
Thorax

Figure

• 

  Fig. 1 Initial ECG showed atrial flutter with 4:1 AV block (A). Postoperative ECG showed normal sinus rhythm (B).

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  Fig. 2 Trans-throracic echocardiography showed a large mobile round mass in the left atrium with central necrosis (A and B).

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  Fig. 3 Hemodynamic change on echocardiographic examination. Severe mitral regurgitation decreased after surgery (A and B). Also peak velocity of tricuspid regurgitation decreased from 4.19 to 1.67 m/s (C and D).

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  Fig. 4 The tumor had a polypoid shape and extensive hemorrhagic and myxoid appearance. (A, Gross findings. 7 × 4 × 3 cm in size, 76 grams). The tumor was composed of round, polygonal, stellate cells surrounded by abundant loose myxoid stroma. (B, Histologic findings. × 100, H & E stain).

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