An 89-year-old woman who had been complaining of shortness of breath on exertion for 11 months presented to the emergency department with paroxysmal nocturnal dyspnea. Chest X-ray revealed cardiomegaly and pulmonary edema (Picture 1). Transthoracic echocardiography showed a left atrial mass (arrow) and severely limited opening of the aortic valve (arrowhead) (Picture 2). The aortic valve was calcific with an increased peak systolic velocity (5.7 m/s) and pressure gradient (mean 83 mmHg), which indicated severe aortic valve stenosis (AS). The next day, the patient underwent excision of the tumor (Picture 3) and aortic valve replacement. The histopathological examination confirmed the diagnosis of myxoma (Picture 4). Large atrial myxoma can sometimes cause an obstruction in the mitral flow, mimicking mitral stenosis (1, 2). In the present case, the combination of large atrial myxoma and severe AS might lead to the aggravation of heart failure. To our knowledge, this is the oldest patient to undergo successful surgical removal for the combination of these two diseases.
Picture 1.
Picture 2.
Picture 3.
Picture 4.
The authors state that they have no Conflict of Interest (COI).
References
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