Atrial Myxoma

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Submitted by Dr T on June 21, 2013 – 11:55am

Question: 
I recently found out that I have a right atrial myxoma. In my case, it seems to cause mainly hematological and immunological alterations (deranged blood coagulation, GI bleeding, proliferation of  B -lymphocytes and vasvulitic-like symptoms/ dermatological signs and poor acral microcirculation) rather than classic heart symptoms. However, some echoes in the past did suggest increased RA pressure (dilated/congested proximal vena cava inf. And hepatic veins) – but at that time, the cause could not be figured out, and the finding was not constant, but recurred regularly.Due to above mentioned symptoms someone finally suggested doing a transesophageal echo and this clearly showed a small myxoma in the right atrium, nearby the entrance of the vena cava into the RA.Now, I have some questions (I havent had consultation with heart surgery yet):1. How long does surgery for myxoma take?2. Is there an increased risk for complications due to resternotomy? (i had a median sternotomy in the past for a mediastinal mass)3. How could the finding by transthoracic echo be explained when it did not show the tumor? 4. I am 26, and have already severe health issues unrelated to the myxoma. However, I read that cafe au lait spots and adrenal overactivity (manifest or subclinical) can go together – i do have 2big and 4 small cafe au lait spots and some unexplained subclinical adrenal issues. Could there be a connection?5. Have you ever had a patient with myxoma that presented with immunological/rheumatological symptoms? If yes, did surgery cure the symptoms?Thank you very much.Sarah

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