Extracardiac complications of heart tumours

Introduction: Primary cardiac tumours are relatively rare clinical entities with a late diagnosis due to unspe-cific manifestations.
Case presentation: A 28-year-old female, non-smoker, was admitted to our hospital with right flank and right iliac fossa pain radiating to the ipsilateral lower limb. The pain was progressive and had had its onset a couple of days ago. The patient had a medical history of spon-taneous abortion, renal microlithiasis and mild anae-mia. Physical examination revealed: fever, sinus bra-dycardia (50-54 bpm), no murmurs, arterial pressure 110/60 mmHg, and positive Giordano sign on the right side. The patient was diagnosed with right renal colic and treated with analgesics and antispasmodics. Blood tests revealed normocytic, hypochromic anaemia and a mild inflammatory syndrome. Abdominal ultrasound revealed renal microlithiasis and a triangular, hypoe-choic area of parenchyma with no Doppler ultrasound signal in the right kidney. Echocardiography revealed a left atrial mass with a diameter of 1.5 cm, hyperechoic, heterogenous, mobile, attached to the interatrial sep-tum. Chest-abdomen-pelvic CT confirms the cardiac mass, as well as an area of right renal infarction. An-ticoagulant treatment is initiated. Preoperative cardiac risk is assesed and the patient is referred to the cardi-ovascular surgery department where the cardiac mass is removed. Histological examination confirms the left atrial myxoma diagnosis. The evolution of the patient is favourable.
Case peculiarity: T he case peculiarity is represented by the specific symptomatology for a renal colic in a patient with a medical history of microlithiasis, whi-ch was suggestive for a kidney disease. The presence of sinus bradycardia in a young patient required an echocardiography, which revealed the left atrial mass.
The peripheral embolization, which led to a right renal infarction, was the clinical onset in this case of atrial myxoma.
Conclusions: Cardiac tumours have a unspecific symp-tomatology and the first manifestations could be due to the embolization of tumour fragments in the periphery, mimicking, thus, other disorders.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)