Left atrial myxomas--a case report.

A 49-year-old woman presented with symptoms of congestive cardiac failure. Cardiac auscultation revealed a crunching sound difficult to characterise in addition to a pansystolic murmur maximally audible in the 4th left intercostal space. The ausculatory findings varied from day to day but were unaffected by posture or exercise. A clinical impression of left atrial myxoma was confirmed by two dimensional echocardiography which revealed a well circumscribed mass almost completely filling the left atrium with a pedicle attached to the interatrial septum. The patient's cardiac failure improved with conservative management using frusemide and digoxin. The patient, however, refused cardiac surgery which is the definitive management of this disease.