Cardiac myxoma

Overview of cardiac myxoma is the most common primary cardiac tumor, mostly benign and malignant rare. Myxoma can occur in the heart of all the endocardial surface, 95% occurred in atrium, about 75% located in the left atrium, 20% located in the right atrium, left ventricle and right ventricle to 2.5% each. Left atrial myxoma tumors often occurred in the vicinity of Waterloo Park eggs, due to clinical tumor mitral valve plug, lead to mitral stenosis or regurgitation, mucinous tumors can occur at any age, but the most common in middle age, female styles. Pathological tumor sizes, and more pedunculated atrial or ventricular wall connected shape diverse, rich, shiny appearance, translucent noticeable. Cut surface substantive, Patchy between bleeding and clotting block filled with small cysts. Under a microscope showed that the tumor cells were from Stelletta tenui Lindgren, spindle, a round or irregular in shape scattered or cords were closed to the mass distribution of myxoid stroma, the nucleus of most of monocytes may also show multinucleated giant cell tumor. Mucinous tumor cell sarcoma different nuclei, dark, we can see nuclear fission, Tumor infiltrating cells to the small vessels within the tumor thrombus formation. Clinical manifestations of this disease depends on the clinical manifestations of the tumor location, size, nature and the availability and pedicle length. 25/42 pedicle elderly prone to cause atrioventricular valve stenosis or regurgitation occurred hemodynamic changes, there was a series of symptoms, small tumor pedicle short, the long-term asymptomatic. 1, the symptoms (1) common early symptoms of obstructive heart palpitations, shortness of breath, reduced exercise capacity, Left atrial myxoma as obstructive pulmonary vein or mitral valve may have mitral valve disease resembles the symptoms of pulmonary bleeding; paroxysmal nocturnal dyspnea, hemoptysis silk sputum, weight can be computed jugular, hepatomegaly and lower extremity edema. Right atrial myxomas as superior vena cava obstruction, tricuspid mouth with pericardial effusion appeared similar symptoms; Jugular venous engorgement. hepatomegaly and edema. The disease with obstructive symptoms of postural changes in the characteristics of the attack and if there are positions related to the paroxysmal vertigo and breathing difficulties. atrioventricular block tumor suddenly aroused valve stroke volume significantly decreased, fainting or sudden cardiac arrest. (2) myxoma debris embolization, or tumor thrombus exfoliated surface can occur, pulmonary embolism cycle. Left atrial myxoma about 40% occurred embolization, right atrial myxoma were rare embolism. (3) systemic symptoms of fever, ESR increase, anemia, weight loss and serum α2, beta globulin abnormal increase, this may be related to tumor necrosis and hemorrhage of inflammatory cell infiltration. 2, signs (1) change the heart of a left atrial myxoma may occur : ① apex of the first heart sound hyperthyroidism. ② pulmonary valve and the second heart sound hyperthyroidism split. ③ left sternal edge under paragraph can be heard early diastolic heart sounds a plop, conduction and cardiac apex and the bottom, the tumor was pushed to the left room suddenly stopped. Ventricular wall or pedicel of vibration generated. In addition, the heart can be heard before the 4th District heart sounds. (2) heart murmur tumor obstruction mitral, tricuspid mouth formed mitral and tricuspid stenosis. When the tumor into ventricular cavity, there will be the atrioventricular valve regurgitation. Insufficiency may interfere with tumor valve is the result of the closure, as a result of tumor repeated contact with the valve. on the valve resulting in scarring similar chronic rheumatic Yan or even lead to tendon rupture, and so the left atrial myxoma. apical diastolic be heard rumbling noise-like, when left lying enhanced when weakened right berth, sometimes be heard with postural changes systolic murmur (mitral regurgitation). Right atrial myxomas, which can be left sternal edge 3 -4 contraction of the intercostal hear-kind of friction between diastolic murmur. Left ventricular heart myxomas can press and the bottom three projectile systolic murmur to the neck conduction, and right ventricular myxoma in the left sternal edge No. 2 -3 intercostal a 2-3 level systolic murmur.