Concurrent Primary Cardiac Tumors in a High-Risk Patient Presenting With Tamponade

Abstract

Primary cardiac tumors are rare, particularly in the elderly population. The patient described in this report presented with symptoms of dyspnea on exertion, leg swelling, and weight gain and was found to have two histologically distinct cardiac masses: atrial myxoma with concurrent aortic fibroelastoma. Given her history of cirrhosis and end-stage renal disease, the patient was a poor surgical candidate but opted for excision of both masses. The patient eventually succumbed to her cirrhosis six weeks after presentation. In this report, we advocate for further research into medical management for the unique presentation of concurrent primary cardiac tumors in high-operative-risk patients, particularly those whose symptoms are mostly due to tamponade.

Keywords: atrial myxoma; emergency echocardiography; imminent mitral annular obstruction; primary cardiac tumors; tamponade.

Figure 1. Chest x-ray (anterior-posterior view)

Figure 2. Transthoracic echocardiogram (TTE) left atrial myxoma 4-chamber view

4CHA - 4 chamber, LV - left ventricular, RV - right ventricular, RA - right atrium

Figure 3. Transthoracic echocardiogram (TTE) left atrial myxoma parasternal long-axis view

PLAX - parasternal long-axis view, RV - right ventricle, LV - left ventricle

Figure 4. Transesophageal echocardiogram (TEE), left atrial myxoma

SVC - superior vena cava