Diagnosis of the right atrial myxoma after treatment of COVID‐19: A case report
Key Clinical Message Atrial myxoma is a rare disease but has a broad clinical presentation and complication that involves several systems‐ heart, lungs, brain, and systemic. An interdisciplinary approach is very important to optimize the outcome in patients with atrial myxomas. A thorough examinatio...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-05-01
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| Series: | Clinical Case Reports |
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| Online Access: | https://doi.org/10.1002/ccr3.7216 |
| _version_ | 1797820444664922112 |
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| author | Mohsen Gholinataj Jelodar Samaneh Mirzaei Hanieh Dehghan Chenari Mahdiyeh Tabkhi |
| author_facet | Mohsen Gholinataj Jelodar Samaneh Mirzaei Hanieh Dehghan Chenari Mahdiyeh Tabkhi |
| author_sort | Mohsen Gholinataj Jelodar |
| collection | DOAJ |
| description | Key Clinical Message Atrial myxoma is a rare disease but has a broad clinical presentation and complication that involves several systems‐ heart, lungs, brain, and systemic. An interdisciplinary approach is very important to optimize the outcome in patients with atrial myxomas. A thorough examination by primary care providers is crucial. Then radiologists or cardiologists can help with imaging modalities that can help diagnose and characterize the tumor. Prior to surgical resection by cardiothoracic surgeons, patients need to be evaluated by pulmonologists, cardiologists, and anesthesiologists for preoperative risk stratifications. In patients with neurological complications, pulmonary complications, or infectious endocarditis, input from neurologists, hematologists, infectious disease specialists is essential for patient care. In case antiplatelet/anticoagulation therapy or antibiotic treatment is warranted, pharmacists can provide valuable recommendations. Abstract Myxoma is the most common benign cardiac primary tumor, occurring in the right atrium in only 15%–20% of cases. This disease is asymptomatic initially depending upon size of the tumor, and symptoms develop as the tumor spreads. Atrial myxomas are associated with a triad of complications, including obstruction, emboli, and constitutional symptoms (such as fever and weight loss). This regard, embolization of the pulmonary circulation system is a complication of right myxoma. The patient was a 40‐year‐old male who presented to the emergency department complaining of fever and confusion. He had been previously hospitalized due to COVID‐19 and treated with Remdesivir and plasmapheresis. He had tachycardia, tachypnea, thrombocytopenia, and increased liver enzymes. Chest imaging showed nodular lesions with necrotic areas and cavitary lesions in both lungs and the right atrium infected clot was seen in echocardiography. He was treated with intravenous antibiotics and finally underwent heart surgery due to the diagnosis of pulmonary septic embolism. The patient was finally diagnosed with right atrial myxoma according to heart mass histopathology. It is worth noting that the patient's thrombosis had already developed on the right atrial myxoma, which delayed the diagnosis in this patient. This thrombus formation was due to the hypercoagulability state of COVID‐19 and following the insertion of a central venous catheter to perform plasmapheresis as a complication of treatment. Special attention should be paid to thromboprophylaxis and the early diagnosis of intravascular and intracardiac thrombosis in COVID‐19 patients. Furthermore, the use of imaging modalities is recommended to differentiate thrombus from myxoma. |
| first_indexed | 2024-03-13T09:38:27Z |
| format | Article |
| id | doaj.art-76bd70a2c586415eb471fe1a7b7c8cb4 |
| institution | Directory Open Access Journal |
| issn | 2050-0904 |
| language | English |
| last_indexed | 2024-03-13T09:38:27Z |
| publishDate | 2023-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj.art-76bd70a2c586415eb471fe1a7b7c8cb42023-05-25T05:58:39ZengWileyClinical Case Reports2050-09042023-05-01115n/an/a10.1002/ccr3.7216Diagnosis of the right atrial myxoma after treatment of COVID‐19: A case reportMohsen Gholinataj Jelodar0Samaneh Mirzaei1Hanieh Dehghan Chenari2Mahdiyeh Tabkhi3Department of Internal Medicine Shahid Sadoughi University of Medical Sciences Yazd IranDepartment of Health in Emergencies and Disasters, School of Public Health Shahid Sadoughi University of Medical Sciences Yazd IranShahid Rahnemoon Hospital Shahid Sadoughi University of Medical Sciences Yazd IranShahid Sadoughi University of Medical Sciences Yazd IranKey Clinical Message Atrial myxoma is a rare disease but has a broad clinical presentation and complication that involves several systems‐ heart, lungs, brain, and systemic. An interdisciplinary approach is very important to optimize the outcome in patients with atrial myxomas. A thorough examination by primary care providers is crucial. Then radiologists or cardiologists can help with imaging modalities that can help diagnose and characterize the tumor. Prior to surgical resection by cardiothoracic surgeons, patients need to be evaluated by pulmonologists, cardiologists, and anesthesiologists for preoperative risk stratifications. In patients with neurological complications, pulmonary complications, or infectious endocarditis, input from neurologists, hematologists, infectious disease specialists is essential for patient care. In case antiplatelet/anticoagulation therapy or antibiotic treatment is warranted, pharmacists can provide valuable recommendations. Abstract Myxoma is the most common benign cardiac primary tumor, occurring in the right atrium in only 15%–20% of cases. This disease is asymptomatic initially depending upon size of the tumor, and symptoms develop as the tumor spreads. Atrial myxomas are associated with a triad of complications, including obstruction, emboli, and constitutional symptoms (such as fever and weight loss). This regard, embolization of the pulmonary circulation system is a complication of right myxoma. The patient was a 40‐year‐old male who presented to the emergency department complaining of fever and confusion. He had been previously hospitalized due to COVID‐19 and treated with Remdesivir and plasmapheresis. He had tachycardia, tachypnea, thrombocytopenia, and increased liver enzymes. Chest imaging showed nodular lesions with necrotic areas and cavitary lesions in both lungs and the right atrium infected clot was seen in echocardiography. He was treated with intravenous antibiotics and finally underwent heart surgery due to the diagnosis of pulmonary septic embolism. The patient was finally diagnosed with right atrial myxoma according to heart mass histopathology. It is worth noting that the patient's thrombosis had already developed on the right atrial myxoma, which delayed the diagnosis in this patient. This thrombus formation was due to the hypercoagulability state of COVID‐19 and following the insertion of a central venous catheter to perform plasmapheresis as a complication of treatment. Special attention should be paid to thromboprophylaxis and the early diagnosis of intravascular and intracardiac thrombosis in COVID‐19 patients. Furthermore, the use of imaging modalities is recommended to differentiate thrombus from myxoma.https://doi.org/10.1002/ccr3.7216COVID‐19myxomaplasmapheresisthrombosis |
| spellingShingle | Mohsen Gholinataj Jelodar Samaneh Mirzaei Hanieh Dehghan Chenari Mahdiyeh Tabkhi Diagnosis of the right atrial myxoma after treatment of COVID‐19: A case report Clinical Case Reports COVID‐19 myxoma plasmapheresis thrombosis |
| title | Diagnosis of the right atrial myxoma after treatment of COVID‐19: A case report |
| title_full | Diagnosis of the right atrial myxoma after treatment of COVID‐19: A case report |
| title_fullStr | Diagnosis of the right atrial myxoma after treatment of COVID‐19: A case report |
| title_full_unstemmed | Diagnosis of the right atrial myxoma after treatment of COVID‐19: A case report |
| title_short | Diagnosis of the right atrial myxoma after treatment of COVID‐19: A case report |
| title_sort | diagnosis of the right atrial myxoma after treatment of covid 19 a case report |
| topic | COVID‐19 myxoma plasmapheresis thrombosis |
| url | https://doi.org/10.1002/ccr3.7216 |
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