Severe functional mitral stenosis due to a left atrial myxoma
Mirsad Kacila1 , Ada Dozic2 , Kenan Rujanac1
1 Heart Center, Sarajevo, Bosnia and Herzegovina
2 Department of Cardiology, General Hospital “Prim.dr. Abdulah Nakas”, Sarajevo, Bosnia and Herzegovina
Corresponding Author: Ada Dozic, MD. Department of Cardiology, General Hospital “Prim.dr. Abdulah Nakas”, Sarajevo, Bosnia and Herzegovina; E-mail: ada.dozic@gmail.com; Phone: +387 33 285-100; ORCID ID: 0000-0002-2664-810X
Cite this article: Kacila M, Dozic A, Rujanac K. Severe functional mitral stenosis due to a left atrial myxoma .
Sar MedJ. 2025; 2(1): Online ahead of print. 
10.70119/0024-25
Pages: -/ Published online: 30 January 2025
Original submission: 24 December 2024; Revised submission: 11 January 2025; Accepted: 21 January 2025
The 71-year-old female patient was admitted for examination due to exertional intolerance. Patient’s medical history included arterial hypertension and hypothyroidism. During the physical examination low-pitched sound during mid-diastole was noted, otherwise there were no remarkable findings. Labo-ratory findings included elevated C-reactive protein and erythrocyte sedimentation rate. There were no specific findings on ECG and chest X-ray. Two-dimensional transthoracic echocardiography (TTE) revealed a left atrial pedunculated mass, which arises from interatrial septum close to the mitral annulus, and prolapses into the mitral orifice in the diastolic phase mimicking severe mitral valve stenosis (MeanG 13 mmHg). 3D transoesophageal echocardiography (TOE) confirmed TTE findings with better assessment of tumor size (4.6 x 2.6 x 2.0 cm) and the site of tumor attachment, providing information that is even more accurate in the planning of surgical treatment. Surgical excision was performed after preoperative preparation in the ICU. Intraoperative finding included ge-latinous, pedunculated left atrial mass ari-sing from the interatrial septum (size 4,5 x3,5 x 2.0 cm). Pathological and immunohi-stochemistry analysis described gelatinous structure consisting of myxoma cells em-bedded in a stroma, positive for calretinin, and negative for S100 protein and actin. A diagnosis of cardiac myxoma was confirmed. Myxomas are the most common type of primary cardiac tumor, with over 75% originating in the left atrium, typically at the mitral annulus or the fossa ovalis border of the interatrial septum (1-3). Patient was discharged after successful recovery (functionally without signs of mitral valve stenosis).
