A patient with polycystic kidney disease, hepatic cysts and atrial myxoma

Abstract

With the development of renal replacement therapy, cardiovascular complications have become the major cause of death in patients with polycystic kidney disease (PKD). Atrial myxoma is a cardiac abnormality that has been rarely reported with PKD. The presence of atrial myxomas is not free of complication as it can cause cardiac outflow obstruction and embolic manifestations ending up in death. Here, we report a case of a 44-year-old female who presented with PKD associated with atrial myxoma. A 44-year-old female presented to the emergency department unconscious with a history of sudden onset of dizziness and palpitation. An urgent electrocardiogram was done and showed supraventricular tachycardia. The patient was sedated and emergency synchronized direct current shock was delivered. She started to regain her conscious and her vital signs started to stabilize. Past medical history revealed our female had left atrial mass discovered 10 months earlier and was surgically excised one month before admission. Histological examination showed this mass was myxoma. Blood investigations at the time of admission showed deranged kidney functions. Urine analysis showed uric acid crystals and microscopic hematuria. Abdominal ultrasound showed bilateral polycystic kidneys, two hepatic right lobe cysts, and bilateral multiple renal stones. Cardiac abnormalities are serious complications that could be associated with PKD and are a major cause of death in this population. Atrial myxomas are a rare association with this condition. Further studies to identify other gene loci in PKD may provide an explanation for the associated cardiac abnormalities.