A Large Right Atrial Myxoma Associated With Atrial Flutter Rhythm

Öz

A 22 year-old man presented to the emergency unit with the complaint of difficulty in breathing. In the physical exam, dyspnea and orthopnea were found. In the electocardiographic exam (ECG) atrial flutter rhythm was seen. The transthoracic echocardiographic exam revealed a large atrial mass that was originating from interatrial septum. During surgery, complete surgical removal of the right atrial mass was successfully performed under moderate hypothermia. Histological investigations revealed a mass of 15 x 3 cm in diameter and the pathological examination showed that the lesion is a myxoma. Twelve months after surgical excision, clinical and echocardiographical follow-up showed a satisfactory exercise tolerance, sinus rhythm in ECG exam, and cardiac functions within normal limits.

Anahtar Kelimeler

• Right atrial myxoma; atrial flutter

Atrial Flutter Ritmi ile Birlikte Görülen Büyük Sa¤ Atrial Miksoma

Öz

22 yafl›nda erkek hasta solunum s›k›nt›s› ile acil servisimize baflvurdu. Fizik muayenesinde, dispne ve ortopne saptand›. Elektrokardiyografisinde (EKG) atrial flutter ritmi gözlendi. Transtorasik ekokardiografisinde sa¤ atriuma yerleflmifl ve interatrial septumdan kaynaklanan bir kitle görüldü. Operasyon s›ras›nda orta dereceli hipotermi uygulanarak sa¤ atriumdaki kitle baflar›l› bir flekilde ç›kart›ld›. 15 x 3 cm çap›ndaki kitlenin histolojik incelemesi atrial miksoma olarak de¤erlendirdi. Cerrahi olarak ç›kart›lmas›ndan 12 ay sonra, klinik ve ekokardiografik takiplerinde yeterli egzersiz tolerans›, EKG'de sinüs ritmi ve normal s›n›rlar içinde kardiyak fonksiyonlar gözlendi.

Anahtar Kelimeler

• Sa¤ atrial miksoma, atrial flutter

Kaynakça

1. Ribbert H. Über das Myxom (about the myxom). Frankfurter Zschr Pathol. 1908;4:30–48
2. Reynen K. Cardiac myxomas N Engl J Med 1995;333:1610-161 33.. Crafoord C.L. Discussion on the results of mitral commissu- rotomy. In: Lam C.R., ed. Proceedings of the International Symposium on Cardiovascular Surgery, Henry Ford Hospital, Detroit, MI. Philadelphia, PA: W.B. Saunders Co, 1955:202-211 44.. Reardon MJ, Smythe WR. Cardiac neoplasms. In: Cohn LH, Edmunds LR, Cardiac surgery in the adult, Second edition, 2003:1374
3. Carney JA: Differences between nonfamilial and familial car- diac myxoma. Am J Surg Pathol 1985; 64:53.
4. Iga K, Izumi C, Konishi T. Rapid growth of a left atrial myxo- maSerial two-dimensional echocardiographic observation over eighteen months. Int J Cardiol 1997;61:85-87
5. Vassiliadis N., Vassiliadis K., Karkavelas G. Sudden death due to cardiac myxoma. Med Sci Law 1997;37:76-78
6. Cilliers A.M., van Unen H., Lala S., Vanderdonck K.H., Hart- man E. Massive biatrial myxomas in a child. Pediatr Cardiol 1999;20:150-151. 99.. Powers JC, Falkoff M, Heinle RA, et al: Familial cardiac myxoma: Emphasis on unusual clinical manifestations. J Tho- rac Cardiovasc Surg 1979; 77:782
7. Peters MN, Hall RJ, Cooley DA, et al: The clinical syndro- me of atrial myxoma. JAMA 1974; 230:695.