J Cardiovasc Ultrasound.  2011 Dec;19(4):221-223. 10.4250/jcu.2011.19.4.221.

Reversible Pulmonary Hypertension in Adolescent with Left Atrial Myxoma

• Kim BK
• Cho JN
• Park HJ
• Hong SP
• Son JY
• Lee JB
• Ryu JK
• Choi JY
• Chang SG
• Kim KS

• KMID: 1980388
• DOI: http://doi.org/10.4250/jcu.2011.19.4.221

Abstract

We report a patient of left atrial huge myxoma presenting with severe pulmonary hypertension in adolescents. A patient was a 14-year-old boy presented with sudden onset dyspnea. Transthoracic echocardiographic study revealed the presence of a nodular, 4.34 x 8.11 cm sized, mobile, hyperechoic mass in the left atrium and severe pulmonary hypertension with tricuspid insufficiency. After surgical therapy, tricuspid regurgitation and pulmonary hypertension was decreased and the patient was stabilized and had an uneventful clinical course.

Keyword

Cardiac tumour; Pulmonary hypertension; Left atrial myxoma

MeSH Terms

Adolescent
Dyspnea
Heart Atria
Humans
Hypertension, Pulmonary
Myxoma
Tricuspid Valve Insufficiency

Figure

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  Fig. 1 Chest X-ray showed mild cardiomegaly and increased pulmonary vascular marking in both lungs.

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  Fig. 2 A: Transthoracic echocardiography showed a 6 × 5 × 4.5 cm sized large left atrial mass (arrow) and right ventricular enlargement in apical 4 chamber view. B: D-shaped left ventricle during diastolic phase in parasternal short axis view (arrowhead).

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  Fig. 3 A: Transthoracic echocardiography after mass removal showed a no visible left atrial mass in apical 4 chamber. B: No D-shaped left ventricle during diastolic phase in parasternal short axis view.

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  Fig. 4 Transthoracic doppler echocardiography showed tricuspid regurgitation with maximal pressure gradient (81.61 mm Hg).

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  Fig. 5 Transthoracic doppler echocardiography after mass removal showed decreased tricuspid regurgitation with maximal pressure gradient (39.37 mm Hg).

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  Fig. 6 Gross specimen of left atrial mass, friable hemorrhagic nodular mass, measuring 6 × 5 × 4.5 cm in size

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