Cardiac myxomas--clinical spectrum and outcome.

OBJECTIVE

To describe the characteristics and outcome of patients with cardiac myxomas.

DESIGN

A case series.

PLACE AND DURATION OF STUDY

The Aga Khan University Hospital (AKUH), from 1999 to 2004.

PATIENTS AND METHODS

All patients diagnosed and managed as having cardiac myxomas at AKUH, during a period of six years (1999-2004) were included. Data was collected by reviewing clinical records. Follow-up data was collected from the clinical records and by a telephone interview where required.

RESULTS

Out of 15 patients who were diagnosed to have cardiac myxomas, complete information was available in 14 patients. There was a female predominance (64%) with a mean age of 47 years. About two-thirds (71%) had symptom of dyspnoea. Half of the patients (50%) had neurological symptoms at presentation. Constitutional symptoms were present in 36% of patients. About two-third of patients (71%) had positive findings on cardiac auscultation. None of the patients had any rhythm abnormalities on the ECG. Diagnosis was made by transthoracic echocardiography in all patients. All of the tumors were located in the left atrium, and majority (64%) were attached to the interatrial septum. All patients were advised surgical treatment, however, only 8 (57%) were operated upon. Outcome was good in those who were operated upon, with no peri and postoperative mortality.

CONCLUSIONS

Cardiac myxomas are a rare, but potentially curable form of heart disease. They occur in a wide range of age groups with a female predominance. Dyspnea is the most common clinical feature followed by embolic complications. Left atrium is the most common site of location. Surgical excision is a safe and effective procedure.