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THINK SYNDROMIC
Abstract   Open access   Peer reviewed

THINK SYNDROMIC

Abdallah Almaghraby, Basma Hammad, Yehia Saleh, Mohammad Seleem, Eman M. El Sharkawy, Mohamed Ayman Abdel hay, Bassem Ramadan and Mohammad Elshafaey
Journal of the American College of Cardiology, Vol.69(11 Supplement), pp.2153-2153
03/21/2017
DOI: 10.1016/S0735-1097(17)35542-0
url
https://doi.org/10.1016/S0735-1097(17)35542-0View
Published (Version of record) Open Access

Abstract

Background: Cardiac myxoma usually presents as a sporadic isolated mass in the left atrium. However, it is rarely presents as multiple masses or in a familial form. Case: A 21-year-old female patient presented with exertional dyspnea and irregular palpitations for the past 3 months. She had past surgical history of excision of recurrent multiple subcutaneous nodules in her left upper arm. Upon examination, she had stable vital signs, palpable thyroid gland and a diastolic rumbling murmur on the tricuspid area. Electrocardiogram showed atrial fibrillation and laboratory investigations were normal except for elevated T3 and T4. Echocardiography showed a large mobile fleshy mass with central constriction attached to the interventricular septum occupying the right atrium and ventricle while obstructing the tricuspid valve flow. In addition to two other smaller masses, the first was in the left ventricle and the second was in the left atrium. Decision-Making: Cardiac magnetic resonance pulse sequences scan was suggestive of myxoma. All three masses were excised however; the tricuspid valve was replaced due to its proximity to the right sided mass. Histopathological examination revealed that all three masses were myxomas, along with her hyperthyroid state and cutaneous lesions that were revealed to be cutaneous myxoma she was diagnosed as Carney complex syndrome. Conclusions: Multicentric cardiac myxoma is an atypical presentation and should warrant screening for possible associated endocrinal disorders.

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