STEMI and NSTEMI ACS in a 30-Year-Old Patient: An Extremely Rare Complication of a Left Atrial Myxoma

Authors

  • Francesco Bartolomucci Division of Cardiology, L. Bonomo Hospital, Andria (BT), Italy
  • Antonio Tito Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, School of Medicine, Policlinico, Bari, Italy
  • Eliano Pio Navarese Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Düsseldorf, Germany
  • Fortunato Iacovelli Interventional Cardiology Service, “Montevergine” Clinic, Mercogliano, Italy; Division of Cardiology, Department of Advanced Biomedical Sciences, University of Napoli “Federico II”, Napoli, Italy
  • Marco Mele Coronary Care Unit-Cardiology Unit, Teresa Masselli Mascia Hospital, San Severo (FG), Italy
  • Claudio Larosa Division of Cardiology, L. Bonomo Hospital, Andria (BT), Italy
  • Marco Matteo Ciccone Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, School of Medicine, Policlinico, Bari, Italy
  • Mauro Cassese Department of Cardiovascular Surgery, Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
  • Martino Pepe Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, School of Medicine, Policlinico, Bari, Italy

DOI:

https://doi.org/10.1532/hsf.1607

Abstract

Primary cardiac tumors are a rare entity whose incidence in the general population ranges from 0.0017% to 0.28%. Myxomas represent nearly half of all primary benign cardiac tumors and they prevalently affect female patients. Embolic manifestation is rare with a reported incidence of 0.06%.

We present the case of a 30-year-old male patient with acute anterolateral infarction caused by total occlusion of the left anterior descending artery as a consequence of a left atrial myxoma embolization. Urgent surgical resection of the mass didn’t avoid early recurrence of atrial myxoma, whose second presentation was again myocardial infarction.

This case alerts physicians to “unusual” myocardial infarction patients, when atherosclerotic pathogenesis appears unlikely. In these cases early echocardiographic evaluation should be mandatory and atrial myxoma should be considered among the possible causes. Complete surgical resection is the only effective therapeutic option to improve prognosis; the chance of tumor recurrence should dictate careful research for additional myxomas during surgery and stricter follow-up planning.

 

References

Abascal VM, Kasznica J, Aldea G, Davidoff R. 1996. Left atrial myxoma and acute myocardial infarction. A dangerous duo in the thrombolytic agent era. Chest 109:1106-8.

Braun S, Schrotter H, Reynen K, Schwencke C, Strasser RH. 2005. Myocardial infarction as complication of left atrial myxoma. Int J Cardiol 101:115-21.

Budzilovich G, Aleksic S, Greco A. 1979. Malignant cardiac myxoma with cerebral metastases. Surg Neurol 11:461-9.

Demir M, Akpinar O, Acarturk E. 2005. Atrial myxoma: an unusual cause of myocardial infarction. Tex Heart Inst J 32:445-7.

Jones DR, Warden HE, Murray GF, et al. 1995. Biatrial approach to cardiac myxomas: A 30-Year clinical experience. Ann Thorac Surg 59:851-6.

Lehrman KL, Prozan GB, Ullyot D. 1985. Atrial myxoma presenting as acute myocardial infarction. Am Heart J 110:1293-5.

Lone RA, Ahanger AG, Singh S, et al. 2008. Atrial myxoma: trends in management. Int J Health Sci (Qassim) 2:141-51.

McAllister HA, Fenoglio JJ. 1978. Tumors of the cardiovascular system-atlas of tumor pathology. 2nd series. Armed Forces Institute of Pathology, Washington DC, pp. 1-3 Fascicle 15.

Milicevic G, Gavranovic Z, Cupic H, Cerovec D, Stipic H, Jukic M. 2008. Unremitting embolus from cardiac myxoma at circumflex artery trifurcation. Int J Cardiol 126:424-6.

Reynen K. 1996. Frequency of primary tumors of the heart. Am J Cardiol 77:107.

Reynen K. 1995. Cardiac myxomas. N Engl J Med 333:1610-17.

Shah IK, Dearani JA, Daly RC. 2015. Cardiac myxomas: A 50-year experience with resection and analysis of risk factors for recurrence. Ann Thorac Surg 100:495-500.

Published

2017-06-30

How to Cite

Bartolomucci, F., Tito, A., Navarese, E. P., Iacovelli, F., Mele, M., Larosa, C., Ciccone, M. M., Cassese, M., & Pepe, M. (2017). STEMI and NSTEMI ACS in a 30-Year-Old Patient: An Extremely Rare Complication of a Left Atrial Myxoma. The Heart Surgery Forum, 20(3), E116-E118. https://doi.org/10.1532/hsf.1607

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