Atrial Myxoma Presenting as Positional Vertigo: A Case Report

Abstract

Cardiac myxoma is an uncommon diagnosis but presents with common manifestations. There is a wide range of symptomatology from non-specific fever and weight loss to stroke-like symptoms. It is also one of the rare causes of cardiac syncope and thromboembolic events. We present a case of a 67-year-old female who presented with seemingly benign vertigo symptoms which she ignored for years before seeking medical attention. An echocardiogram revealed a 3.5 x 3.0 x 1.0 cm atrial myxoma which was surgically excised. Her symptoms have resolved entirely with no recurrence since surgery.

Keywords: atrial myxoma; myxoma; syncope; vertigo.

Figure 1. Transesophageal echocardiogram depicting left atrial myxoma (white arrow).

Figure 2. Areas of the heart visible from a transesophageal echocardiogram with myxoma in the left atrium.

Figure 3. Low power magnification showing an abundance of mucopolysaccharide matrix of myxoid stroma mixed with papillary projections and stellate cells mixed with blood vessels.

Figure 4. High power magnification showing hemosiderin macrophages with islands of stellate cells.

Figure 5. Diffuse spindle-shaped stroma with mixed myxoid cells.