Left Atrial Myxoma Presented with an Obstructive Shock, Right Ventricle Dysfunction and Pulmonary Hypertension

Abstract

Myxoma is a benign primary cardiac tumour, mostly located in the left atrial. A 43 years old woman was referred with a difficulty of breathing for 3 months. The patients also complained about weakness, swollen legs, enlarged abdomen, and blood-tinged cough. The patient appeared weak with blood pressure of 80/50 mmHg and grade III/IV systolic and diastolic murmurs were found. Transthoracic echocardiography and pathology evaluation conclude a cardiac myxoma. The patient was diagnosed with a LA myxoma with an obstructive shock, right ventricular (RV) dysfunction and pulmonary hypertension, thus a surgical approach was done immediately to prevent embolism and sudden death. Cardiac features are most likely a consequence of obstructed LV inflow. Transthoracic echocardiography is a useful modality to determine the size, location, and mobility of the mass. The persistence of RV dysfunction post-surgical may be due to the chronicity of the myxoma.