Atrial Myxoma

Atrial myxomas are the most common primary tumor of the heart. The majority (>80%) are located in the the left atrium attached to atrial septum, usually at the fossa ovalis.

Clinical Issues

The main clinical concern in embolization, which happens more often with villous tumors (about 1/3 of myxomas are vollous). The myxoma may also become infected, resulting in septic emboli. If the myxoma obstructs the mitral or tricuspid valve, symptoms of valvular stenosis may be seen.

Imaging

Echocardiography is the modality of choice for evaluation. Plain films are almost always normal. 50% of myxomas in the right atrium calcify (rare in left atrium), which may be seen on radiographs.

Differential Diagnosis

• thrombosis
• metastasis
• cardiac lipoma
• lymphoma