Giant Left Atrial Myxoma Presenting with Cough-Syncope Syndrome

Abstract

We report the case of a 41-year-old female patient with symptoms of cerebrovascular accident manifesting with loss of consciousness during episodes of cough. Computed multislice chest tomography showed a 7.3- by 4.15-cm mass in the left atrium. A transesophageal echocardiogram showed a giant mass in the left atrium that passed through the mitral valve to the left ventricle, and severe obstructive stenosis was suggested by the mean transmitral gradient. After a comprehensive assessment of the mass, we decided to perform surgery. The pedunculated and fragile mass was attached to the interatrial septum with its handle, and the majority of it prolapsed through the mitral valve to the left ventricle and became stacked among the mitral valve leaflets. The removed mass was analyzed histopathologically and was found to be a myxoma. It is important for the cardiac surgeon to surgically remove an atrial myxoma because of the risks associated with embolization, including sudden death, as myxoma can block the blood supply from the atrium to the ventricle.