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Atrial myxoma

Cardiac tumor - myxoma; Heart tumor - myxoma

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An atrial myxoma is a noncancerous tumor in the upper left or right side of the heart. It most often grows on the wall that separates the two sides of the heart. This wall is called the atrial septum.

Causes

A myxoma is a primary heart (cardiac) tumor. This means that the tumor started within the heart. Most heart tumors start somewhere else.

Primary cardiac tumors are rare. Myxomas are the most common type of these rare tumors. About 75% of myxomas occur in the left atrium of the heart. They most often begin in the wall that divides the two upper chambers of the heart. The rest are in the right atrium. Right atrial myxomas are sometimes linked with tricuspid stenosis and atrial fibrillation.

Myxomas are more common in women. About 1 in 10 myxomas are passed down through families (inherited). These tumors are called familial myxomas. They tend to occur in more than one part of the heart at a time, and often cause symptoms at a younger age.

Symptoms

Many myxomas will not cause symptoms. These are often discovered when an imaging study (echocardiogram, MRI, CT) is done for another reason.

Symptoms may occur at any time, but often they go along with a change in body position.

Symptoms of a myxoma may include:

The symptoms and signs of left atrial myxomas often mimic mitral stenosis (narrowing of the valve between the left atrium and the left ventricle). Right atrial myxomas rarely produce symptoms until they have grown to be quite large (5 inches wide, or 13 cm).

Other symptoms may include:

Exams and Tests

The health care provider will perform a physical exam and listen to your heart through a stethoscope. Abnormal heart sounds or a murmur may be heard. These sounds may change when you change body position.

Imaging tests may include:

You may also need blood tests including:

Treatment

Surgery is needed to remove the tumor, especially if it is causing heart failure symptoms or an embolism. Some people will also need the mitral valve replaced. This can be done during the same surgery.

Myxomas may come especially back if surgery does not remove all of the tumor cells.

Outlook (Prognosis)

A myxoma is not cancer, but complications are common.

Untreated, a myxoma can lead to an embolism (tumor cells or a clot that breaks off and travels in the bloodstream). This can lead to a blockage of blood flow or even cause the tumor to grow in another part of the body. Pieces of the tumor can move to the brain, eye, or limbs.

If the tumor grows inside the heart, it can block blood flow. This may require emergency surgery to prevent sudden death.

Possible Complications

Complications may include:

References

Lenihan DJ, Yusuf SW, Shah A. Tumors affecting the cardiovascular system. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 95.

Mckenna WJ, Elliott P. Diseases of the myocardium and endocardium. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 60.

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  • Left atrial myxoma

    Left atrial myxoma

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  • Right atrial myxoma

    Right atrial myxoma

    illustration

    • Left atrial myxoma

      Left atrial myxoma

      illustration

    • Right atrial myxoma

      Right atrial myxoma

      illustration

     

    Review Date: 5/16/2018

    Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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