Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2017;70:497 - Vol. 70 Num.06 DOI: 10.1016/j.rec.2016.10.001

Calcified Left Atrial Myxoma

Pablo Robles Velasco a,, Isabel Monedero Sánchez a, Elena Magallanes Ribeiro a

a Unidad de Cardiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain

Article

Full English text available from: www.revespcardiol.org/en

A 93-year-old patient presented to the emergency room of our hospital with fever. Twenty years earlier, she had been incidentally diagnosed with left atrial myxoma measuring 7 mm in diameter, with limited mobility attached to the atrial septum. At the time, the patient refused resection surgery and did not return for follow-up. The chest radiograph revealed cardiomegaly and a rounded calcified image on the cardiac silhouette (Figure 1, arrows). Transthoracic echocardiography (Figure 2, arrows) showed a calcified mass measuring 1 × 5 cm attached to the atrial septum with an associated acoustic shadow of limited mobility, consistent with a calcified left atrial myxoma (Video of the Supplementary Material). She was diagnosed with a urinary infection. In view of the clinical progression, her age, and her prior refusal of surgery, a conservative approach was chosen.

Figure 1.

Figure 2.

Usually, myxoma is resected after diagnosis. This is clearly the preferred approach when the patient is symptomatic. This case is of interest given the doubts about the approach to take in asymptomatic patients at high surgical risk or those who refuse surgery. Echocardiographic findings such as a smooth surface and calcification suggest lesion stability and limited progression. Calcification is an infrequent finding in atrial myxoma. Visualization of myxoma in a radiograph because of calcification is a rare occurrence.

SUPPLEMENTARY MATERIAL

Video

Corresponding author: problesve.pr@gmail.com

1885-5857/© 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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