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  1. Pulmonary edema of an unexpected cause
    Abdullah HN, Khairina WW
    South. Med. J., 2008 Oct;101(10):1035-7.
    PMID: 18791521 DOI: 10.1097/SMJ.0b013e31817fbeb8
    Atrial myxoma is rarely seen in practice. We report a 67-year-old female who presented with acute cardiac insufficiency and pulmonary edema. Cardiac murmur was not detected on precordial examination. Urgent echocardiography, however, revealed atrial myxoma causing mitral valve obstruction. We point out that a normal cardiac examination does not exclude atrial myxoma. The diagnosis may be delayed until significant myocardial dysfunction occurs, as reported here. The clinical presentation of cardiac myxoma is discussed, along with appropriate investigations and treatment.
    Matched MeSH terms: Mitral Valve Stenosis/complications
  2. Percutaneous transvenous mitral commissurotomy in patients with severe kyphoscoliosis
    Ramasamy D, Zambahari R, Fu M, Yeh KH, Hung JS
    Cathet Cardiovasc Diagn, 1993 Sep;30(1):40-4.
    PMID: 8402863
    Because transseptal catheterization is felt to be contraindicated in patients with severe kyphoscoliosis, there have been no reports of percutaneous transvenous mitral commissurotomy performed in such patients. This report describes percutaneous transvenous mitral commissurotomy in three patients with severe thoracic kyphoscoliosis, with special emphasis on the transseptal puncture technique. Biplane right atrial angiography and the contrast septal flush method are very useful in landmark selection for a safe transseptal puncture.
    Matched MeSH terms: Mitral Valve Stenosis/complications
  3. Fulltext Biatrial thrombi resembling myxoma regressed after prolonged anticoagulation in a patient with mitral stenosis: a case report
    Lu HT, Nordin R, Othman N, Choy CN, Kam JY, Leo BC, et al.
    J Med Case Rep, 2016 Aug 10;10(1):221.
    PMID: 27510438 DOI: 10.1186/s13256-016-1018-0
    BACKGROUND: Many cases of cardiac masses have been reported in the literature, but in this case report we described a rare case of biatrial cardiac mass that represented a challenge for diagnosis and therapy. The differentiation between cardiac masses such as thrombi, vegetations, myxomas and other tumors is not always straightforward and an exact diagnosis is important because of its distinct treatment strategy. Transthoracic/esophageal echocardiography and cardiac magnetic resonance play an important role in establishing the diagnosis of cardiac masses. However, no current noninvasive diagnostic tool has the ability to absolutely diagnose cardiac masses; obtaining a pathological specimen by surgical resection of cardiac masses is the only reliable method to diagnose cardiac masses accurately. Our case report is an exception in that the final diagnosis was affirmed by empirical anticoagulation therapy based on clinical judgment and noninvasive characterization of biatrial mass.

    CASE PRESENTATION: We described a 54-year-old Malay man with severe mitral stenosis and atrial fibrillation who presented with a biatrial mass. Transthoracic/esophageal echocardiography and cardiac magnetic resonance detected a large, homogeneous right atrial mass typical of a thrombus, and a left atrial mass adhering to interatrial septum that mimicked atrial myxoma. The risk factors, morphology, location, and characteristics of the biatrial cardiac mass indicated a diagnosis of thrombi. However, our patient declined surgery. As a result, the nature of his cardiac masses was not specified by histology. Of note, his left atrial mass was completely regressed by long-term warfarin, leaving a residual right atrial mass. Thus, we affirmed the most probable diagnosis of cardiac thrombi. During the course of treatment, he had an episode of non-fatal ischemic stroke most probably because of a thromboembolism.

    CONCLUSIONS: Noninvasive characterization of cardiac mass is essential in clarifying the diagnosis and directing treatment strategy. Anticoagulation is a feasible treatment when the clinical assessment, risk factors, and imaging findings indicate a diagnosis of thrombi. After prolonged anticoagulation therapy, complete resolution of biatrial thrombi was achievable in our case.

    Matched MeSH terms: Mitral Valve Stenosis/complications
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