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Postgrad Med J 88:671-672 doi:10.1136/postgradmedj-2011-130653
  • Images in medicine

A rare presentation of chest pain and syncope: massive right atrial myxoma

  1. Hickman Michael2
  1. 1London Deanery, Cardiology Trainee, London, UK
  2. 2Department of Cardiology, Royal Surrey County Hospital, London, UK
  1. Correspondence to Dr Rahman, Mohammed Shamim, London Deanery, Cardiology Trainee, London, UK; shamimrahman{at}doctors.net.uk
  1. Contributors MSR: wrote the case, collected the images. MH: reviewed the case, consultant in charge of care of the patient, edited and approved the final draft.

Cardiac tumours, found in approximately 0.19% of unselected patients at post-mortem,1 are most frequent in women (female:male; 17:7) and are generally found in the left atrium.2 The vast majority are benign and nearly half are myxomas. Right atrial myxomas are rarer still, accounting for between 5% and 23% of all myxomas and reported through case reports and single-centre experience.3 ,4 Transthoracic echocardiography can identify myxomas through their classic appearance as well defined masses that are heterogeneous and are attached to the interauricular septum by a stalk. Consideration must be given to the differential diagnoses, which includes atrial thrombus, other benign tumours such as lymphangioma, leiomyoma or haemangiomas and malignant tumours such as angiosarcoma, leiomyosarcoma and metastatic deposits of systemic cancer. …