Benign primary cardiac tumors are uncommon and malignant tumors are rare. Metastatic tumors occur more often than primary tumors of the heart, but rarely cause functional disturbances. A left atrial myxoma is the most common cardiac tumor and is usually symptomatic.
Symptoms include fever, weakness, malaise, Raynaud’s phenomenon, and finger clubbing. The diagnosis may be missed because of nonspecific findings. Cardiac symptoms include shortness of breath on exertion, paroxysmal nocturnal dyspnea, syncope, and palpitations. Emboliza-tion of tumor fragments may cause transient cerebral ischemia attacks or small strokes. Embolization may occur to the limbs causing limb ischemia. Multiple emboliza-tion may mimic vasculitis or infective endocarditis.
Mobile pedunculated left atrial myxomas may pro¬lapse into the mitral valve orifice causing obstruction to blood flow that results in syncope or cardiogenic shock. Symptoms and signs may mimic mitral stenosis (see the chapter Valve Diseases). Arrhythmias such as supraventri-cular tachycardia, ventricular premature beats, and occa¬sionally ventricular tachycardia may occur. The patient’s sedimentation rate is usually markedly elevated and transesophageal echocardiography should be diagnostic. MRI is also helpful in confirming the diagnosis. Surgical removal of the lesion usually produces a complete cure.