K J Somaiya Hospital Super Special Centre has gained a reputation for treating complex heart conditions. We share one such patient case.
Primary cardiac tumours are rare and depending on location and size can cause serious blood flow problems or blockages of the blood supply, which can be life-threatening.
A 42-year old male patient from a small town of Maharashtra was brought to the K J Somaiya Super Specialty Hospital. The patient had been experiencing occasional chest pain since 5-6 months, along with shortness of breath on exertion and perspiration. Initially, he had been treated at various hospitals in his hometown for fever and extreme generalised weakness, but later as complaints increased, he was referred to the K J Somaiya Super Specialty Hospital.
The patient presented with nonspecific chest pain symptoms including shortness of breath (dyspnea) when lying flat, attacks of severe shortness of breath and coughing at night, pulmonary oedema, cough, coughing up of blood, oedema, and fatigue. These symptoms could be due to a number of serious disorders considered a medical emergency
The evaluation and management of the patient with chest pain symptoms is a diagnostic challenge to all who practice emergency medicine. Faced with a wide range of possible diagnoses, the judgment to consider atrial myxoma was a critical one. Diagnosing an LA myxoma can be difficult because of its rarity and the varied presentation, and needs expertise and experience to diagnose and treat one in time.
Diagnostic evaluation
The goal of the initial evaluation was to ascertain the presence of a cardiac tumour, and if present the location of the lesion within the heart and, to the extent possible, whether the tumour was benign or malignant. This information would be vital in planning further evaluation and management.
On conducting a 2D Echo, the procedure revealed Left atrial myxoma mass a noncancerous tumour in the upper left side of the heart – on the (atrial septum) the wall that separates the two sides of the heart. It also showed Mitral valve-AML long and floppy, no mitral regurgitation, Grade 2 diastolic dysfunction and LVEF-60%.
Dr Sadanand Shetty, Consulting Cardiologist, K J Somaiya Hospital Super Specialty, performed a coronary angiography via right radial route- S/O normal coronaries.
Once a presumptive diagnosis of myxoma was made on imaging studies, prompt resection was required because of the risk of embolisation or cardiovascular complications, including sudden death.
The open heart surgery for LA Myxoma mass excision surgery needs to be performed by a highly skilled Cardiovascular and Thoracic Surgeon.
The successful procedure was performed by Dr Nitin Gundre, Honorary Consultant, CVT K J Somaiya Hospital- Super Specialty Centre in which the Large 6.5 x 5cm pedunculated, lobulated, myxomatous LA mass was removed under General Anaesthesia and sent for histopath examination.
Post-operative care the patient recovered well and went home.
The K J Somaiya Super Specialty Hospital, with its reputation for high-quality, affordable healthcare, sophisticated intensive care facilities and expert doctors, has become a valued tertiary care referral centre for patients from across the state.