J Med Assoc Thai 1999; 82 (2):107

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Atrial Myxoma : A Review of Clinical Experience at Srinagarind Hospital
Silaruks S Mail, Kiatchoosakul S , Tatsanavivat P , Tontisirin C , Kuptarnond C , Prathanee S , Pachirat O , Klungboonkrong V

Thirty-two intracardiac myxoma patients who underwent tumor excision in Srinagarind
Hospital between January 1, 1983 and January 30, 1997 were retrospectively revicwed.Ciinical
presentations, diagnostic method, operative findings, and postoperative course were also analysed.
There were 20 female and 12 male patients, age range 10 to 60 years (mean 37.9). Clinical presentations
included congestive heart failure (56.2% ), atypical chest pain (25.0% ), syncope (18 .9o/c ),
and constitutional symptoms (9.3% ). In six patients, there was clinical evidence of systemic
embolism. One patient was essentially asymptomatic and incidentally detected during clinical
check-up. Diagnosis was all made by two dimensional (2-D) echocardiographic study. There
were 29 left atrial, 2 right atrial and I combined right atrial and right ventricular myxomas. There
were 3 postoperative deaths, two due to septicemia and the other due to cerebral embolism. One
patient developed postoperative severe mitral regurgitation and complete heart block needed
mitral valve replacement and permanent pacemaker insertion. One patient developed localized
seizure 6 years after resection and was suspected of brain metastasis. The other was found to have
two high echogenic liver masses, 2 years after resection, suggestive of hepatic metastasis. Unfortunately,
we could not obtain the histologic confirmation from any of those suspected lesions.
Because of the non-specific and various manifestations of atrial myxoma, a high index of
suspicion is needed. The diagnostic method of choice is 2D-echocardiography. Clinical follow-up
for at least I 0 years may be needed to rule out recurrence or metastasis.
Key word : Atrial Myxoma, Clinical Experience, Srinagarind Hospital

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