Objective: To gain insight into the occurrence, the manifestation and the treatment of cardiac myxoma.
Design: Retrospective.
Setting: The departments of Cardiology and Cardiac Surgery of Middelheim General Hospital, Antwerp, Belgium.
Patients and results: Thirteen patients in the period 1985-1995 were subjected to surgical resection of a cardiac myxoma. In accordance with earlier studies, most patients were middle-aged and female. The site of predilection was the left atrium. Cardiac auscultation suggested mitral valve stenosis and insufficiency in three and five patients, respectively; in only one case was the specific 'tumour plop' heard. Cardiac symptoms were atypical thoracic pain (4 times), syncopes (3) and effort dyspnoea (7). Although embolism is described in the literature in 20-70% of the cases, it occurred in only three patients of this group. General symptoms were observed in only seven patients, as against 90% in earlier studies: they were elevated sedimentation rate in five (one also polycythaemia and leucocytosis) and abnormal fatigue in two (one also anorexia) patients. In all 13, the diagnosis of 'intracardiac mass' was made on the basis of ultrasonography. In six of 11 patients who subsequently underwent coronary roentgenography, neovascularization was visualized. All 13 tumours were resected successfully, after which in ten cases a dacron patch was implanted at the level of the interatrial septum. In addition, two patients underwent coronary bypass surgery. Postoperatively, atrial flutter (two patients), atrial fibrillation (one) and fatal cerebral bleeding (one) were observed. The other patients suffered no recurrences.
Conclusion: Cardiac myxoma is a rare tumour which in general can be accurately diagnosed on the basis of ultrasonography and which almost always can be cured by surgical excision.