Myxoma natural history
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2] Ahmad Al Maradni, M.D. [3]
Overview
Complications that can develop as a result of myxoma are: arrhythmias, pulmonary edema, peripheral emboli, metastasis, blockage of the mitral heart valve.
Natural History
Initially, patients will start with constitutional symptoms that may also resemble those of endocarditis, followed by either valvular obstruction or embolic events. Since most of the cardiac myxomas are left sided, its commonly reported to present systemic embolic events (e.i stroke). On the other hand, valvular obstruction can present as pulmonary edema,dyspnea and orthopnea. Approximately 20% of patients with cardiac myxoma are asymptomatic.
If left untreated, patients with left cardiac myxoma may progress to develop mitral valve obstruction, having a clinical onset of dyspnea, orthopnea, pulmonary edema and heart failure. On the other hand, right atrial myxomas may obstruct the tricuspid valve and cause symptoms of right-sided heart failure. Overall, clinical features of cardiac myxoma are strongly related with the size of the tumor,location, size and mobility(e.i sessile tumors are mobile tumors, they can cause positional symptoms[1].
Complications
Complications are common. Some of the complications that may develop as a result of myxoma are:[2]
- Peripheral emboli
- Blockage of the mitral heart valve
- Syncope
- Arrhythmias
- Pulmonary edema
- Metastasis
- Sudden death
- Fusiform cerebral aneurysms
Prognosis
Depending on the complications derivated from the cardiac myxoma at the time of diagnosis (embolic event or valve obstruction) the prognosis may vary. However with no complications, the prognosis is generally regarded as favorable after surgery. Recurrence rates (either locally or elsewhere in the heart) reported in 1-3% of cases. In atypical cases the rate is much higher (12-22%).[3] However, if left untreated, a myxoma may progress to develop embolism, cardiac arrhythmias, and death. If the tumor grows inside the atrium, it obstructs blood flow through the mitral valve and cause symptoms of mitral stenosis. The survival rates after 5-years are 83% for benign heart tumors.[4]
References
- ↑ Burke A, Virmani R. Tumors of the Heart and Great Vessels. Amer Registry of Pathology; 1996.
- ↑ Atrial myxoma. Wikipedia https://en.wikipedia.org/wiki/Atrial_myxoma Accessed November 13, 2015
- ↑ Prognosis-Cardiac Myxoma.Radiopedia http://radiopaedia.org/articles/cardiac-myxoma Accessed on November 13,2015
- ↑ Hoffmeier A, Sindermann JR, Scheld HH, Martens S (2014). "Cardiac tumors--diagnosis and surgical treatment". Dtsch Arztebl Int. 111 (12): 205–11. doi:10.3238/arztebl.2014.0205. PMC 3983698. PMID 24717305.