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A 54 year old woman was admitted to hospital because of worsening effort dyspnoea during the previous six months. She was hypercholesterolaemic without any family history of cardiac disease or malignancies. Physical examination revealed a diastolic murmur, ECG was normal, and chestx ray showed signs of moderate pulmonary congestion. Transoesophageal echocardiography showed a large left atrial myxoma (51 × 31 × 37 mm), arising from the atrial septum (arrow) and protruding into the mitral valve orifice during diastole. Coronary angiography was performed to exclude the presence of treatable coronary artery disease. Right coronary artery angiogram revealed a large artery (internal diameter about 2.0 mm) that supplied the myxoma (arrow) through neoformed clusters of small tortuous vessels (arrow heads).
The mass was successfully removed by surgical excision of the root of the myxoma and the surrounding interatrial septum followed by closure of the residual septum defect with a Dacron patch. Pathological analysis of the tumour confirmed the clinical diagnosis of left atrial myxoma.