P349Left atrial myxoma hypervascularized: case report and literature review

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Introduction: We present the case of a patient admitted electively in general cardiology unit complaining of chest pain for 5 months. Research by an imaging compatible with intra atrial tumor hypervascularized.

Case Report: Woman, 40, in evaluation for chest pain type B for five months. Physical examination without significant changes and chest X-ray, electrocardiogram and laboratory normal. By means of echocardiography, including transesophageal approach, sessile lesion found in the left atrium of 33 mm in diameter. A hypothetical diagnosis of atrial myxoma. Requested angiography, excluding coronary artery disease, and observed a tumor irrigated by a large branch of the right coronary artery with marked neovascularization(Figure 1), proceeded by complete excision of the same. Pathologic examination confirmed the diagnosis of atrial myxoma, noting intense vascular proliferation. The patient was discharged asymptomatic.

Discussion: vascularization of the tumor grade enough to be visualized by coronary arteriography is considered rare in cases of atrial myxoma. The irrigation is the right coronary artery and the circumflex artery fewer or both, with the blood supply of the tumor may change its operating strategy. The hypervascularity of atrial myxoma may also cause theft coronary blood with consequent myocardial ischemia; few cases illustrate this uncommon clinical. The treatment of choice for atrial myxoma is surgical removal, the possibility of embolism or sudden death, and the same curative.

Conclusion: Atrial myxoma presents itself as the most common primary cardiac tumor, although in this case manifesting atypically by intense neovascularization. This fact encourages the investigation of differential diagnoses with literature review and updating of the subject.

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