Myxoma natural history
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]Maria Fernanda Villarreal, M.D. [3]
Overview
Cardiac myxoma progression occurs slowly, the overlapping of various phenomena such as thrombosis, hemorrhage, or fragmentation may influence tumor growth, detachment, and consequently embolism. Complications that can develop as a result of myxoma are: arrhythmias, pulmonary edema, peripheral emboli, metastasis, blockage of the mitral heart valve. The survival rates after 5-years are 83% for benign heart tumors.[1]
Natural History
If left untreated, cardiac myxoma progression occurs slowly. The overlapping of various phenomena such as thrombosis, hemorrhage, or fragmentation may influence tumor growth, detachment and consequently embolism.[2] Constitutional symptoms, such as: weight loss, fatigue, weakness are often the initial clinical onset of cardiac myxoma, and may resemble those from endocarditis. Metastases are very uncommon in cardiac myxoma.
Since the majority of the cardiac myxomas are left sided, it may progress to develop mitral valve obstruction or systemic embolic events, such as cerebral stroke. Whereas, right atrial myxomas may obstruct the tricuspid valve and can present as right sided heart failure. Approximately 20% of patients with cardiac myxoma are asymptomatic. Overall, clinical features of cardiac myxoma are associated with the size of the tumor, location, size and mobility.[3]
Complications
Complications are common. Some of the complications that may develop as a result of myxoma are:[4]
- Peripheral emboli
- Blockage of the mitral heart valve
- Syncope
- Arrhythmias
- Pulmonary edema
- Metastasis
- Sudden death
- Fusiform cerebral aneurysms
Prognosis
Depending on the complications derivated from the cardiac myxoma at the time of diagnosis (embolic event or valve obstruction) the prognosis may vary. However with no complications, the prognosis is generally regarded as favorable after surgery. Recurrence rates (either locally or elsewhere in the heart) reported in 1-3% of cases. In atypical cases the rate is much higher (12-22%)[5] . The survival rates after 5-years are 83% for benign heart tumors.[1]
References
- ↑ 1.0 1.1 Hoffmeier A, Sindermann JR, Scheld HH, Martens S (2014). "Cardiac tumors--diagnosis and surgical treatment". Dtsch Arztebl Int. 111 (12): 205–11. doi:10.3238/arztebl.2014.0205. PMC 3983698. PMID 24717305.
- ↑ Markel ML, Waller BF, Armstrong WF (1987). "Cardiac myxoma. A review". Medicine (Baltimore). 66 (2): 114–25. PMID 3547010.
- ↑ Burke A, Virmani R. Tumors of the Heart and Great Vessels. Amer Registry of Pathology; 1996.
- ↑ Atrial myxoma. Wikipedia https://en.wikipedia.org/wiki/Atrial_myxoma Accessed November 13, 2015
- ↑ Prognosis-Cardiac Myxoma.Radiopedia http://radiopaedia.org/articles/cardiac-myxoma Accessed on November 13,2015