Review Article Atrial myxoma: a review

rd to 5 th decade of life are the common sufferers, but no age is exempt. Patients may present with dyspnea, palpitation, embolization, congestive heart failure, neurologic symptoms, systemic illness, pain chest/limbs, pyrexia or weight loss. Clinical examination may reveal accentuated apical first heart sound, systolic murmur, tumor plop, loud pulmonic component, anaemia, asthenia, hypertension, paresis or plegia of limbs, or sudden cardiac arrest. Symptomatology and clinical signs may be misleading and the diagnosis is made by transthoracic echocardiography. Transesophageal echocardiography though invasive is superior to transthoracic echocardiography. Patients presenting with peripheral embolization need doppler studies, computed tomography. Magnetic resonance imaging may be needed to differentiate atrial myxoma from other cardiac tumors. Early surgical intervention for atrial myxomas which is done on urgent basis mitigates morbidity and usually offers cure. Jugular cannulation is avoided, heart is approached by median sternotomy but right anterior thoracotomy is equally good. Cannulation is done gently and aorta cross clamped before cardioplegia, right atriotomy approach is sufficient to remove the whole tumor along with its base and adjacent septal wall. Thorough saline irrigation / suction of atrium and ventricle remove all the tumor emboli. The defect so created is repaired directly or with a patch. Recurrence may be there but the Long term results are excellent. If asymptomatic, high risk patients should be followed with echocardiographic examination.