http://journal.chestnet.org/article/S0012-3692(21)04512-8/fulltext#relatedArticles
What to make of this? "Tumors of the heart"?
TYPE: Case Report
TOPIC: Cardiothoracic Surgery
INTRODUCTION: Primary cardiac tumours such as myxomas are rare. About 75% of myxomas occur in the left atrium of the heart. We present a case of an unusually huge left atrial myxoma discovered incidentally in a patient with COVID-19.
CASE PRESENTATION: A 64-year-old woman presented to the emergency department with 2 days of high fever, dyspnea, and non-productive cough. Chest computed tomography (CT) showed moderate bilateral pleural effusion and multilobar bilateral lung consolidation with ground-glass opacities suggestive of COVID-19. Transthoracic echocardiography revealed a 70x 50 mm highly mobile mass in the left atrium, with a typical feature of myxoma. Surgical operation was deferred until after the patient’s COVID-19 infection had resolved with a negative PCR test for COVID-19. Three weeks later, after she had recovered completely from the infection, she successfully underwent resection of the tumour.
DISCUSSION: Myxomas are the most common cardiac tumours. Our patient demonstrates some interesting features. Firstly, the asymptomatic giant left atrial myxomas are rare. When the tumour is located close to the mitral valve, it results in obstruction and presents with symptoms of left heart failure symptoms and pulmonary congestion. Despite being so large, there were no obvious associated symptoms in our case. Secondly the mass diagnosis incidentally during underlying COVID-19 disease. Thirdly differentiating between myxoma, and other cardiac masses such as mural thrombus is still a challenge especially in COVID-19 patients.
CONCLUSIONS: Cardiac myxomas are uncommon tumours. In our case, the patient was asymptomatic. In COVID-19 patients developing hemodynamic instability, surgical intervention should be done as soon as possible.
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