Dizzy spells in pregnancy: successful antenatal removal of a huge left atrial myxoma with mitral valve obstruction

BMJ Case Rep. 2024 Mar 7;17(3):e259675. doi: 10.1136/bcr-2024-259675.

Abstract

Diagnosing atrial myxoma in pregnancy is challenging because patients may present with non-specific symptoms that might be overlooked. The timing of non-obstetric operation usually depends on the nature of the disease, after careful consideration of feto-maternal safety, including the use of cardiopulmonary bypass and placental transfer of anaesthetic drug. A woman in her 30s at 18 weeks of pregnancy presented with recurring dizziness. She underwent successful myxoma excision at 20 weeks under general anaesthesia and cardiopulmonary bypass. The 6×5 cm myxoma was histologically confirmed as myxoma. Early detection of atrial myxoma in pregnancy is crucial, and a clinician has to consider the diagnosis of left atrial myxoma with mitral valve obstruction as a cause of severe dizziness. Optimal outcomes require multidisciplinary management. In this case, surgery during the second trimester of pregnancy enabled a full-term pregnancy with the patient's and foetal well-being and normal postprocedural echocardiography.

Keywords: Cardiovascular medicine; Radiology (diagnostics).

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Dizziness
  • Female
  • Heart Atria / diagnostic imaging
  • Heart Atria / surgery
  • Heart Neoplasms* / complications
  • Heart Neoplasms* / diagnostic imaging
  • Heart Neoplasms* / surgery
  • Humans
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / surgery
  • Mitral Valve Insufficiency* / surgery
  • Myxoma* / complications
  • Myxoma* / diagnostic imaging
  • Myxoma* / surgery
  • Neoplasm Recurrence, Local / complications
  • Placenta
  • Pregnancy
  • Vertigo