gms | German Medical Science

24. Jahrestagung der Deutschen Gesellschaft für Arterioskleroseforschung

Deutsche Gesellschaft für Arterioskleroseforschung

18.03. - 20.03.2010, Blaubeuren

Increasing dyspnoea caused by an intracardiac mass in the right atrium

Meeting Contribution

  • corresponding author S. Szabo - Kardiologische Gemeinschaftspraxis, Langenfeld, Germany
  • T. Oikonomopoulos - Klinik für Kardiologie und Allgemeine Innere Medizin, Städtisches Klinikum, Solingen, Germany
  • R. Marx - Fachklinik Rhein/Ruhr, Essen Kettwig, Germany
  • H. M. Hoffmeister - Klinik für Kardiologie und Allgemeine Innere Medizin, Städtisches Klinikum, Solingen, Germany

Deutsche Gesellschaft für Arterioskleroseforschung e.V.. 24. Jahrestagung der Deutschen Gesellschaft für Arterioskleroseforschung. Blaubeuren, 18.-20.03.2010. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc10dgaf07

DOI: 10.3205/10dgaf07, URN: urn:nbn:de:0183-10dgaf072

Published: March 23, 2011

© 2011 Szabo et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Patient presentation

Increasing dyspnoe is a frequent cause of a cardiologic consultation. A 39-year old female patient has been admitted to our institution because of increasing dyspnoea since 2–3 months.

In her medical history, there was no mental or physical illness. Furthermore, we found no abnormal immobilization. The patient was non-smoker, but she had a hyperlipidemia and a positive family history of cardiovascular diseases. A previously performed pulmonary function test and a computed tomography scan of the lung showed no abnormalities, however the radiologist described a cardiomegaly.

On physical examination, there were no abnormal findings. The electrocardiogram showed a sinus rhythm with 70 beats per minute, normal qrs complex, no st-segment changes. In the echocardiography, there was a normal left-ventricular systolic function, no myocardial hypertrophy could be seen. Furthermore, the patient had a mild insufficiency of both the mitral and tricuspidal valve, and a large, nearly free-floating round soft mass with a diameter of 3 cm in the right atrium could be detected (Figure 1 [Fig. 1], Figure 2 [Fig. 2]).

A preoperative diagnostic procedure was performed with no other pathological findings. The intraatrial mass was resected by minimal invasive cardiac surgery. Histological and immunopathological findings showed a thrombus, no malignancy or other specific changes were present.

After an uneventful postoperative course, the patient was discharged at home. During a follow-up evaluation after 3 months, she did well, her dyspnoe significantly has improved.

Progressive exertional dyspnoea in younger patients often remains a diagnostic challenge. Thereby, an intracardiac mass is a rare cause of dyspnoe [1]. In this setting, atrial myxomas are the most common benign primary tumor of the heart occuring in as many as 3 in 1000 patients [2]. However, thrombi as well as primary malignant tumors of the heart or metastasis of primary extracardial tumors also have to be taken into account during further evaluation of progressive dyspnoe in younger patients.


References

1.
Peters PJ, Reinhardt S. The echocardiographic evaluation of intracardiac masses: a review. J Am Soc Echocardiogr. 2006; 19: 230-40. DOI: 10.1016/j.echo.2005.10.015 External link
2.
Percell RL Jr, Henning RJ, Siddique Patel M. Atrial myxoma: case report and a review of the literature. Heart Dis. 2003; 5: 224-30. DOI: 10.1097/01.hdx.0000074515.95567.92 External link