A rare cause of myocardial infarction - coronary artery embolization by myxoma fragments

Abstract

Introduction. Myxoma is the most common intracardiac tumor accounting for about 50% of all heart tumors. The symptoms depend on the size of the tumor, its location and mobility. Embolic manifestations of coronary arteries are extremely rare, occurring in about 0.06% of cases, and they are caused by tumor fragments. Case Report. A 54-year-old female patient was admitted for an acute myocardial infarction with ST segment elevation in the inferior leads. Urgent coronary angiography was performed showing no coronary vessel stenosis. In the projection of the left atrium, a mobile mass with partial calcification was registered, which was stained to a lesser extent with a contrast agent. These were nutrient vessels with a typical ?tumor blush? sign. An echocardiographic examination showed a round, inhomogeneous mass in the left atrium, which was fixed to the interatrial septum. The findings were presented to the cardiology team and urgent surgical extirpation was performed. During the follow-up period of two years, the patient was doing well and echocardiographic examination showed a normal finding, without recurrence of the tumor. Conclusion. Acute myocardial infarction in people without risk factors for ischemic heart disease is very rare. The most common cause of this type of acute coronary syndrome is spontaneous coronary artery dissection. Acute myocardial infarction caused by embolization of the coronary artery by myxoma fragments is a rare phenomenon. Echocardiographic examination is the method of choice in the diagnosis of myxoma. The most effective treatment for these patients is surgical resection of the tumor with low operative mortality.