bubble_chart Overview

Cardiac myxoma is a common benign tumor of the heart, mostly attached near the fossa ovalis of the interatrial septum. About 3/4 occur in the left atrium, while approximately 1/5 occur in the right atrium. Cases involving multiple chambers simultaneously are extremely rare. Although myxomas are benign, incomplete resection can lead to recurrence, and literature reports indicate that microtumor emboli can cause distant implantation and recurrence. Shedding of tumor tissue can result in circulatory embolism. Severe obstruction of valve orifices by mobile tumor masses can cause syncope or even sudden death. Therefore, once diagnosed, early surgical treatment is recommended, with highly satisfactory therapeutic outcomes.

bubble_chart Clinical Manifestations

1. Symptoms of circulatory disturbance: palpitation, shortness of breath, orthopnea, syncope, heart murmurs (diastolic or systolic, biphasic) that change with body position. 2. Symptoms of cerebral embolism or pulmonary embolism: hemiplegia, unconsciousness, aphasia, etc.; pulmonary embolism may lead to shock, dyspnea, chest pain, hemoptysis, etc. 3. Systemic symptoms: fever, weight loss, lack of strength, anemia, joint pain, increased erythrocyte sedimentation rate, etc.

bubble_chart Diagnosis

1. Palpitation, shortness of breath, hemiplegia, and heart murmurs that sometimes change with body position. 2. Chest X-ray shows enlargement of the left atrium and right ventricle, with pulmonary congestion; fluoroscopy reveals calcification in the tumor, with the calcified shadow moving with the heartbeat. 3. Echocardiography shows the tumor moving with cardiac contraction and relaxation.

bubble_chart Treatment Measures

1. Strict bed rest; 2. For patients with cardiac insufficiency, administer cardiotonic and diuretic therapy to improve cardiac function, and perform emergency or early hypothermic extracorporeal circulation surgery to remove intracardiac tumors; 3. Before the main arterial pulse is occluded during surgery, avoid moving the heart or conducting intracardiac and extracardiac exploration; 4. The tumor pedicle at the atrial septum or atrial wall, endocardium, and myocardium should be completely excised; if the heart valve is invaded and cannot be repaired, perform valve replacement; for valve regurgitation due to annular dilation, perform annuloplasty; for large excisions of the atrial septum, perform patch repair. 5. The cardiac incision should be large enough to facilitate complete tumor removal; 6. After tumor removal, thoroughly irrigate the cardiac chamber to prevent residual tumor fragments.

Patients with unexplained sudden palpitations and shortness of breath that progressively worsen, especially if symptoms are aggravated or relieved by positional changes, should be highly suspected of this condition. Prompt echocardiography should be performed. Once diagnosed, the tumor should be excised under direct vision during extracorporeal circulation surgery, and the prognosis is favorable.

bubble_chart Cure Criteria

1. Cure: Symptoms and signs disappear, with no complications. 2. Improvement: Symptoms are alleviated, but palpitation persists. 3. No recovery: Symptoms show no improvement.