ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Cardiac myxoma: a rare cause of acute myocardial infarction
Shi-Min Yuan
Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, China
DOI : 10.5606/tgkdc.dergisi.2016.11033
Background: This study aims to investigate the clinical features of acute myocardial infarction secondary to cardiac myxoma.

Methods: Data source of the study was based on a comprehensive retrieval of the English literature between the dates January 1st 1990 and August 31st 2014. A total of 48 patients (mean age 45.2±15.3 years; range 9 to 70 years) with acute myocardial infarction secondary to cardiac myxoma were included in the study.

Results: Most patients had an acute onset with chest pain being the prevailing onset symptom accounting for 75.6%. Majority of the patients had elevated serum myocardial enzyme levels. Inferior myocardial infarction was the most frequent followed by anterior myocardial infarction. A normal coronary artery was found in 20 patients (48.8%), coronary occlusive lesion in 21 patients (51.2%), while coronary conditions were not given in seven patients. Cardiac myxoma was diagnosed solely by transthoracic echocardiography in 83.7% of the patients and 93.3% of the cardiac myxomas were in the left atrium. Conservative management including thrombolytic and/or anticoagulant therapies was described in 17 patients (35.4%). Two patients had sudden death without an opportunity for surgical treatment. A surgical resection of the myxoma was performed in 44 patients (95.7%). Percutaneous coronary intervention failed in two patients (40%). As a result, there were 38 (88.4%) event-free survivals, three (7.0%) survivals with disabilities, and two (4.7%) deaths.

Conclusion: In young patients with acute myocardial infarction without apparent risk factors of coronary artery disease, a myxoma-related acute myocardial infarction should be considered and an echocardiographic screening is necessary for a differential diagnosis with conventional coronary artery disease. Coronary angiogram is crucial in identifying the status of coronary emboli and for decision-making for further management. Associated peripheral embolic events frequently warrant an embolectomy.

Keywords : Acute coronary syndrome; cardiac surgical procedures; myxoma
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