Case 4: Heart failure and weight loss

A 71-year-old male presented with congestive heart failure, retrosternal chest discomfort and weight loss. His apex was displaced laterally and downwards and he had a loud, palpable first heart sound.

Echocardiography showed an 8.5 by 5 by 4 cm mobile mass in the left atrium attached to the distal interatrial septum prolapsing through the mitral valve orifice during diastole.

The diagnosis of myxoma was made on the basis of left atrial location, attachment to the atrial septum and the presentation. The tumor was surgically removed by left atriotomy and the diagnosis confirmed by histology.

The pedunculated left atrial myxoma (8.5 by 5 by 4 cm) after removal.

Two-dimensional transthoracic echocardiogram (parasternal view, long axis) showing 
a left atrial mass lesion prolapsing through the the mitral valve orifice in diastole.

Removal of the tumor by left atriotomy during cardio-pulmonary bypass after
cardioplegic arrest.