Untypical cause of heart failure – right atrial myxoma

The study presents case of a 62-year-old female patient with symptoms of the heart failure NYHA class III intensifying for the last 2 months. In the physical examination at admission no significant abnormalities were found. In the two- and three-dimensional echocardiography normal thickness and contractility of the left ventricle wall were found, as well as the normal systolic function of the right ventricle. In enlarged right atrium a structure of the oval shape was found with the features of continuity with atrial septum and bulging of a small part of the structure through the orifice of the tricuspid valve to the right ventricle. In the study no features of blocking the tricuspid flow or the inflow from the main veins and coronary sinus were detected. On the basis of the complete echocardiographic examination and clinical presentation tentative diagnosis of right atrium myxoma was made. In coronary angiography no significant abnormalities in coronary arteries were found. After cardio-surgical consultation the patient was scheduled for the surgical removal of the tumor, which was performed without complications. The histopathological examination confirmed the diagnosis of myxoma. In the follow-up echocardiography carried out after 8 months the reduction of the cavity of the right atrium was found and a good function of the ventricles. There were no features of the tumor re-growth.