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Cardiac Myxoma : Clinical Features

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Clinical Presentation of Cardiac Myxomas (continued from the previous two images):

Constitutional symptoms are more frequent in women and in right-sided myxomas. They include fever, fatigue, weakness, arthralgias and weight loss. They are caused by release of cytokines such as interleukin-6, TNF-α and others by tumor cells.

Laboratory findings include: elevated erythrocyte sedimentation rate (ESR), leukocytosis, polycythemia, thrombocytopenia, and polyclonal hypergammaglobulinemia.

The diagnosis is usually established with two-dimensional echocardiography. Transesophageal echocardiography, CT and MRI are useful in locating tumor attachment site and differentiating it from mural thrombus and atrial sarcomas.

This cardiac CT is from an adult female who presented with breathlessness. The heart is enlarged. A low density filling defect occupies almost the entire right atrium. It appears attached to the inter-atrial septum. The tumor was resected and the diagnosis of atrial myxoma was confirmed on histology. Case courtesy of Frank Gaillard, Radiopaedia.org. From the case rID: 8544

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