Atrial myxoma presenting as infective endocarditis.
Gerald Paul FitzgeraldJohn Joseph CoughlanZahir SattiSamer ArnousPublished in: BMJ case reports (2018)
A 23-year-old Asian student presented to our service with a 1-month history of fever, weight loss of 10 kg, night sweats, fatigue and general malaise. He was previously well with no significant medical or family history. He had a low-grade pyrexia and cardiac auscultation revealed a diastolic murmur consistent with 'tumour plop'. He had no sequelae of endocarditis. He had low-grade pyrexia of 37.7°C, and ECG showed sinus tachycardia at 130 bpm. He had raised inflammatory markers and was started on broad spectrum antibiotics. Blood cultures grew Streptococcus viridans twice. Transthoracic and transo-oesophageal echocardiography revealed a large mobile mass attached to the interatrial septum, suspicious for atrial myxoma, flopping into the left ventricle but not causing left ventricular outflow tract obstruction. All valves looked normal in appearance. He was treated with antibiotics for 2 weeks until inflammatory markers normalised. The patient was referred for cardiothoracic surgery where a large atrial myxoma (5 cm×3 cm) was excised just superior to the mitral valve. It had areas of necrosis and was colonised with S. viridans He had an unremarkable postoperative course and made a complete recovery.
Keyphrases
- low grade
- left ventricular
- mitral valve
- left atrial
- high grade
- catheter ablation
- weight loss
- hypertrophic cardiomyopathy
- atrial fibrillation
- cardiac resynchronization therapy
- healthcare
- heart failure
- acute myocardial infarction
- aortic stenosis
- minimally invasive
- bariatric surgery
- single cell
- mental health
- sleep quality
- aortic valve replacement
- patients undergoing
- coronary artery bypass
- case report
- aortic valve
- heart rate variability
- candida albicans
- depressive symptoms
- type diabetes
- roux en y gastric bypass
- blood pressure
- cystic fibrosis
- biofilm formation
- percutaneous coronary intervention
- escherichia coli
- metabolic syndrome
- surgical site infection
- transcatheter aortic valve implantation
- obese patients
- acute coronary syndrome