Atrial & Other Myxomas: Symptoms, Tests & Treatment
Synopsis: Information regarding types of myxomas - a primary heart tumor - including symptoms and treatments.1
Author: Disabled World Contact: Disabled World
An atrial myxoma is a noncancerous tumor in the upper right or left side of a person's heart. The tumor grows on the wall that separates the two sides of the heart. The wall is called the, 'atrial septum.'
A myxoma is a myxoid tumor of primitive connective tissue. It is the most common primary tumor of the heart in adults, but can also occur in other locations. Myxomas are usually removed surgically. The surgeon removes the myxoma, along with at least 5 surrounding millimeters of atrial septum. The septum is then repaired, using material from the pericardium.
A, 'myxoma,' is a primary heart tumor. What this means is that the tumor began within the person's heart. The majority of heart tumors begin somewhere else.
Primary cardiac tumors are rare. Myxomas are the most common type of these rare tumors. Approximately 75% of myxomas happen in the left atrium of a person's heart, commonly starting in the wall that divides the two upper chambers of the heart. The rest are in the right atrium. Right atrial myxomas are at times associated with atrial fibrillation and tricuspid stenosis.
Myxomas are more commonly experienced by women. Around 1 in 10 myxomas are passed down through families. These tumors are called, 'familial myxomas.' They tend to happen in more than one part of the person's heart at a time and often cause symptoms while a person is still younger.
The symptoms of a myxoma can happen at any time, although they most often occur when a person changes the position of their body. The symptoms associated with myxomas are many. These symptoms can include the following:
- Heart palpitations
- Chest tightness or pain
- Breathing difficulty when sleeping
- Breathing difficulty while lying flat
- Shortness of breath while pursuing physical activity
The symptoms and signs of left atrial myxomas often times mimic mitral stenosis. Right atrial myxomas rarely produce symptoms until they have grown to be at least five inches wide. Additional symptoms of myxomas may include:
- Joint pain
- Raynaud's phenomenon
- Unexpected weight loss
- Swelling of any part of the body
- Fingers that change color with pressure
- Curvature of nails accompanied with soft tissue swelling of the fingers
Myxoma Tests and Signs
A doctor or a nurse will perform a physical examination and listen to the person's heart using a stethoscope. A murmur or abnormal heart sounds may be detected. The sounds might change when the person changes the position of their body. A doctor may also order some different imaging tests, which could include:
- Heart MRI
- Chest X-ray
- Doppler study
- CT scan of the chest
- Left heart angiography
- Right heart angiography
A doctor may also order some different blood tests. These tests may include a complete blood count, erythrocyte sediment rate, or white blood cell count.
Myxoma Radiographic features
A doctor may examine an affected person using different types of Radiographic tests. The tests may include plain film and/or an MRI scan among others. What follows are descriptions of these tests.
Plain Film: A person with a myxoma might have chest X-rays that appear, 'normal.' Abnormalities; if they are present, are non-specific and might include left atrial enlargement, intracardiac tumoral calcification, evidence of mitral valve obstruction, or evidence of elevated left atrial pressure.
Echocardiography: Echocardiography is usually the first modality used for identification and evaluation of cardiac myxomas. They appear as hyperechogenic lesions with a well-defined stalk. Echocardiography may be useful in assessing the mobility of the person's tumor because it often protrudes through valve flaps.
MRI Scan: MRI appearances are heterogeneous, reflecting the non-uniformity of these masses. They are usually avoid or spherical masses that might be pedunculated or sessile.
T1: Tend to be low to intermediate signal, yet areas of haemorrhage could be high.
T2: May be variable due to heterogeneity in tumor components such as calcific components.
Gradient Echo: Gradient echo may show blooming of calcific components.
T1 C+: Shows enhancement, an important discriminator from a thrombus.
Myxomas, as with other forms of cardiac tumors, appear in intra-cardiac masses, most often in the person's left atrium and attached to the interatrial septum. The tumors are usually heterogeneously low attenuating. Due to repeated episodes of haemorrhage, dystophic calcification is common. If the mass is pedunculated, the motion within the person's heart can be demonstrated, to include prolapse through the mitral valve.
Treatment for a myxoma requires surgery in order to remove the tumor. Some people will also need their mitral valve replaced. Mitral valve replacement can be done during the same surgery to remove the person's tumor. Complete resection is usually curative with recurrence rates, either locally or elsewhere in the person's heart, reported in 1-3% of instances. An atypical instances the rate is higher at 12-22%. Myxomas may return if surgery failed to remove all of the tumor cells.
While a myxoma is not cancer, complications commonly occur. Left untreated, a myxoma might lead to an embolism or tumor cells breaking off and traveling through the person's bloodstream, which may block the flow of blood or cause the tumor to grow in another part of the person's body. Pieces of the tumor can move to the person's eye, brain, or their limbs. If the tumor grows inside the person's heart, it may block the flow of blood. The result might be emergency surgery to prevent the sudden death of the person.
Some different complications are associated with myxomas. These complications may include arrhythmias, pulmonary edema, spread of the tumor, peripheral emboli, or blockage of the person's mitral heart valve.
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