Advertisement

Left atrial myxoma

Phonocardiographic clues to diagnosis
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Phonocardiographic clues to the diagnosis of left atrial myxoma based on 3 cases are presented. Vibrations during the isovolumic period following a first heart sound of increased amplitude, along with simultaneous vibrations in the systolic upstroke of the apex cardiogram, are clues to the presence of a left atrial myxoma. These vibrations probably are associated with its movement (sudden acceleration and deceleration of the tumor and surrounding blood). Similar vibrations may be recorded phonocardiographically during the isovolumic relaxation period. The presence of a long Q-S1 or short A2-EDS (early diastolic sound) interval is not helpful in differentiating left atrial myxoma from mitral stenosis. When the clinical findings suggest severe mitral stenosis, a long A2-EDS should raise suspicion of a left atrial myxoma. Systolic, diastolic and presystolic murmurs may occur either in mitral stenosis or with left atrial myxoma and are not of themselves helpful in differentiation, unless there is unusual temporal or postural variation, or both, in these murmurs.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Jones G.P.
        • Julian D.G.
        Left atrial tumor simulating mitral stenosis.
        Brit. M. J. 1955; 2: 361
        • Davis Jr., F.W.
        • Andrus E.C.
        Mitral stenosis in facsimile.
        New England J. Med. 1954; 251: 297
        • Zitnik R.S.
        • Burchell H.B.
        Phonocardiographic studies in patients with left atrial myxomas and with total prosthetic mitral valve replacements (Abstr.).
        in: Proc. New England Cardiovas. Soc.21. 1962: 14
        • Pitt A.
        • Pitt B.
        • Schaefer J.
        • Criley J.M.
        Myxoma of the left atrium: Hemodynamic and phonocardiographic consequences of sudden tumor movement.
        Circulation. 1967; 36: 408
        • Penny J.L.
        • Gregory J.J.
        • Ayres S.M.
        • Gian-Nelli Jr., S.
        • Rossi P.
        Calcified left atrial myxoma simulating mitral insufficiency: Hemodynamic and phonocardiographic effects of tumor movement.
        Circulation. 1967; 36: 417
        • Schaefer J.
        • Schwarzkopf H.J.
        • Nieder-Mayer W.
        Änderungen der Herzdynamik bei Vorhoftumoren durch plǒtzliche Volumenverschiebungen während der Anspannungsphase.
        Klin. Wcknschr. 1966; 44: 1344
        • Bower P.J.
        • Ritter D.G.
        • Callahan J.A.
        • Zitnik R.S.
        Unusual hemodynamic findings of diagnostic value in a case of left atrial myxoma.
        Am. J. Cardiol. 1969; 23: 592
        • Lefcoe N.M.
        • Brien F.S.
        • Manning G.W.
        An opening snap recorded in a case of tumor of the left atrium.
        New England J. Med. 1957; 257: 178
        • Wassermil M.
        • Warkentin D.L.
        • Ravin A.
        Myxoma of the left atrium: Phonocardiographic study of three cases.
        Circulation. 1962; 25: 50
        • Abbott O.A.
        • Warskawski F.E.
        • Cobbs Jr., B.W.
        Primary tumors and pseudotumors of the heart.
        Ann. Surg. 1962; 155: 855
        • Harvey W.P.
        Clinical aspects of cardiac tumors.
        Am. J. Cardiol. 1968; 21: 328
      1. Ongley, P. A., Sprague, H. B., Rappaport, M. B. and Nadas, A. S. Heart Sounds and Murmurs: A Clinical and Phonocardiographic Study, p. 164, Fig. 68

        • Ongley P.A.
        • Sprague H.B.
        • Rappaport M.B.
        • Nadas A.S.
        Heart Sounds and Murmurs: A Clinical and Phonocardiographic Study.
        in: Grune & Stratton, New York1960: 165 (Fig. 69)
        • Tafur E.
        • Cohen L.S.
        • Levine H.D.
        The normal apex cardiogram: Its temporal relationship to electrical, acoustic, and mechanical cardiac events.
        Circulation. 1964; 30: 381