Acute bicaval obstruction as a result of intracapsular haemorrhage in a right atrial myxoma : report of a case

Right atrial myxomas are rare and presentation is characterised by the gradual onset of one or more of a triad of constitutional, obstructive, or embolic symptoms. We describe a case in which interstitial haemorrhage within a right atrial myxoma resulted in rapid expansion and presentation with features of rapidly progressing bicaval obstruction and atrial flutter. Transthoracic echocardiography failed to detect this tumour; however, transoesophageal echo clearly displayed it and gave information on its attachment and relations which proved to be valuable in the planning of its surgical excision.