A treatable cause of heart failure

Abstract

A 72-year-old woman with history of type 2 DM, HT and dyslipidaemia was asymptomatic until 3 months earlier, when she reported a 15-kg weight loss. Also, she had been feeling progressively worsening effort dyspnoea for a month and dyspnoea at rest, orthopnoea and paroxysmal nocturnal dyspnoea for 8 days. An outpatient echocardiogram revealed a bulky mass in her left atrium (LA). She was referred to the emergency room, being subfebrile with polypnea, tachycardia and a peripheral saturation of 81%. A new echocardiogram showed a bulky mass with irregular contours (78x30mm) in her LA, which had its pedicle at the level of the lower fossa ovalis, was mobile with a protrusion to the left ventricle (LV) going past the ventricular middle region and was obstructing the LV entry tract, with an estimated pulmonary artery systolic pressure of 86 mmHg. She underwent a myxoma excision and an interatrial septoplasty. Afterwards, she was asymptomatic.