Left atrial myxoma moving from right atrium to left ventricle. Non-invasive and invasive techniques and surgical findings.

A case of left atrial myxoma, prolapsing through a large atrial septal defect during systole and through the mitral valve orifice during diastole, is presented. To our knowledge this is the third such case and only the second one in which the diagnosis was made before operation. Echocardiography and phonocardiography were of great value in establishing the diagnosis of left atrial myoxoma; the features before and after operation are presented. In this patient the "swinging" of the tumor in the left atrium and in the left ventricle was echocardiographically visible. Correlations of tumor movement and heart sounds could be made. The diagnosis of a 36% left-to-right shunt on atrial level could not be made with the help of non-invasive techniques alone; cardiac catheterization revealed the shunt. The role of non-invasive techniques and of cardiac catheterization is discussed, together with a review of the relevant literature.