Left Atrium Myxoma, Closed - Female, 73 Years

Left Atrial Myxoma:

Atrial myxoma is the most common primary tumor of the heart, originating from the inner lining or
Endocardium. Tumors involving the heart can be classified as primary (originating in the heart) or
secondary(Metastatic spread from another part of the body to the heart). Metastases are more
common, typically present in late-stage disease, and can occur in 1-20% of cancer patients,
depending on the type of primary tumor. Primary cardiac tumors are rare and range from 0.02-0.3%
of the population. Atrial myxomas are benign but can still be life-threatening due to their location in
the left atrium, where it may obstruct blood flow through the mitral valve, cause arrhythmias, or
embolize to other organs. They are slow-growing tumors, which are most commonly present due to
obstructive symptoms (shortness of breath, fainting, fatigue or palpitations, pulmonary
hypertension, or heart failure) and less commonly due to embolic symptoms such as stroke, organ
infarction, or peripheral artery occlusion.

Anatomy: Left Atrium

The left atrium (LA) is one of four chambers of the heart that receives oxygenated blood from the
lungs through the 4 pulmonary veins (2 from the left lung and 2 from the right vein). It delivers
oxygenated blood through the mitral valve into the left ventricle, which is then pumped to the rest of
the body. The left atrium contains unique anatomic features, including the left atrial appendage, a
small ear-shaped muscular pouch whose function, while not entirely understood, helps regulate
cardiac output and blood pressure and contracts during diastole. It is a common place for
thrombus to form during arrhythmias such as atrial fibrillation and may need to be surgically
occluded or occluded through minimally invasive procedures. The interatrial septum separates the
left and right atrium and is the most common site for atrial myxomas to arise. The Mitral valve is a
bicuspid valve separating the left atrium from the left ventricle and ensures one-way blood flow into
the ventricle when normal.

Diagnosis:

Atrial myxomas are diagnosed through imaging, including transthoracic echocardiography (TTE),
transesophageal echocardiography (TEE), Cardiac CT, or Cardiac MRI. Although not always
present, a triad of symptoms of mitral valve obstructions, embolism, and constitutional symptoms
can lead to further investigation, commonly starting with echocardiography.

Treatment:

In most cases, surgical excision is the mainstay of treatment and curative with an excellent long-
term prognosis. Follow-up imaging may be used to monitor for recurrence or residual disease after
surgery.