Management Of A Case Of Left Atrial Myxoma Presenting With Right Ventricular Dysfunction And Pulmonary Artery Hypertension Case report

Abstrakt

Left atrial myxomas are rare primary cardiac tumors, accounting for approximately 0.5% of all cardiac tumors per million individuals annually. Although histologically benign, their strategic location and potential for obstructive or embolic complications often render them clinically significant. These tumors predominantly arise from the interatrial septum and may present with a constellation of non-specific systemic and cardiorespiratory indications, mimicking various cardiac or pulmonary pathologies. A middle-aged subject with progressive dyspnea, fatigue, and signs of cardiorespiratory compromise was studied in this case study. Initial laboratory investigations revealed elevated renal parameters suggestive of end-organ involvement or hypoperfusion. Further evaluation with two-dimensional echocardiography (2D ECHO) revealed the presence of a large left atrial mass, consistent with a myxoma, prolapsing through the mitral valve during diastole. Associated findings included severe pulmonary artery hypertension (PAH) and right ventricular (RV ) dysfunction. The left ventricular ejection fraction (EF) was preserved at 55%, indicating isolated right-sided compromise. The patient was hemodynamically stabilized using appropriate medical management prior to surgical intervention. Optimization involved correction of fluid balance, management of renal function, and supportive treatment for RV dysfunction and PAH. Once stable, the case experienced successful surgical excision of the tumor via median sternotomy and cardiopulmonary bypass. Histopathological examination established the identification of atrial myxoma. The postoperative recovery was predominantly unremarkable, with gradual improvement in cardiopulmonary function and normalization of renal parameters. This case highlights the importance of early recognition and comprehensive evaluation of cardiac tumors, particularly myxomas, which can have life-threatening consequences if not promptly diagnosed and managed.