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| Definition | A primary cardiac tumor involving the connective tissue within the heart, which can be located in the right upper chamber (atrium). See also atrial myxoma; left . |
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| Causes, incidence, and risk factors | Primary tumors of the heart are rare. Most tumors in the heart are the result of spreading ( metastasis ) from other tumors. Of the primary cardiac tumors, myxomas are the most common. Over 80% of myxomas are in the left atrium ( atrial myxoma; left ), usually beginning in the intraventricular septum and growing into the atrium. Right atrial myxomas are very rare, occurring in about 1 out of 1,000,000 people. Myxomas are more common in women. Risk factors include a having a personal or family history of cardiac myxoma ( heart tumor ). Other risks include a having a history of bowel infarction (tissue death), or a history of peripheral , pulmonary (lung), or systemic emboli . Right atrial myxomas may also be associated with tricuspid stenosis and atrial fibrillation . |
| Symptoms | chest pain or tightness swelling of the hands, feet, or any body part ( edema ) swelling of the abdomen prominent veins in the neck shortness of breath ( dyspnea ) dyspnea on exertion dyspnea when flat ( orthopnea ) dyspnea when asleep ( paroxysmal nocturnal dyspnea ) dizzinessfainting ( syncope ) sensation of feeling the heart beat ( palpitations ) Note: Symptoms may occur with change of body position or at any time. Other symptoms that may be present include: coughfever involuntary weight loss of more than 5% of body weight general discomfort ( malaise ) joint pain blueness ( cyanosis ) of skin, especially fingers with cold or emotional stress curvature of nails accompanied with soft tissue enlargement ( clubbing ) of fingers awakening at night to urinate ( nocturia ) |
| Signs and tests | Symptoms may mimic right-sided heart failure . Examination with a stethoscope ( auscultation ) of the heart may show "tumor plop" (a sound related to movement of the tumor ) or other abnormal sounds. Neck veins may be distended. Examination of the eyes may show retinal tissue damage due to cessation of blood supply (infarction). An echocardiogram may show myxoma or tricuspid stenosis. Right atrial myxoma may show on: an MRI of chest a CT scan of chest a coronary angiography a chest X-ray An ECG may show atrial fibrillation . Lab tests may be nonspecific. A CBC indicates anemia . Sedimentation rate is decreased. |
| Treatment | The only effective treatment is surgical removal of the tumor . |
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| Expectations (prognosis) | The probable outcome is poor without treatment. Although a myxoma is a benign tumor , complications occur. Movement of tumor cells ( metastasis ) can occur if clots form (tumor cells can travel with the clot ). Growth of the tumor can obstruct blood flow through the heart. Myxomas are curable with surgical removal. |
| Complications | arrhythmiasheart failureperipheralemboli (clots) pulmonary emboliblood clots to other organs |
| Calling your health care provider | Call your health care provider if symptoms indicate an atrial myxoma may be present. This may be hard to recognize but your health care provider may diagnose this with an echocardiogram. |
| Prevention | Prevention is unknown. Awareness of risk can make early detection and treatment possible. |
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