“Tumor cardiaco de etiologia no determinada, probable mixoma”

Abstract

The aim of this clinical case is to reveal the relevance of cardiac myxoma as one of the most common tumors in the population. An 83-year-old patient with a medical history is reported: benign prostatic hypertrophy, atrial fibrillation, congestive heart failure, hypothyroidism; with surgical history: cholecystectomy; which presents a mid-range dyspnea picture, of 12 hours of evolution, usually secondary to short walks accompanied by orthopnea, in addition to chest pain of oppressive type of mild intensity without irradiation, intermittent and palpitations sensation, familiar refers to remarkable loss of weight in the last 6 months. Physical examination, tachycardia (134 beats per minute), tachypneic (32 breaths per minute), oxygen saturation of 90%, slightly icteric scleras, neck presence of bilateral jugular ingurgitation, skin thorax and teguments without alterations, discrete adipose panniculus, expansibility preserved, thrill preserved without the presence of subcostary retractions. Lungs: on conserved vesicular murmur auscultation, slight crepitations in lung bases. Heart: arrhythmic heart sounds, first sounds accentuated in apex, holosystolic grade III / IV in mitral focus. Extremities: edema in lower limbs ++ / +++ from pretibial region.

Echocardiogram depressed left ventricular function; ejection fraction of the left ventricle 45%; a hyperechogenic image plus interauricular communication is observed; Right ventricle and right atrium with enlarged diameter, a giant tumor located in the right and left atria is observed.

A presumptive diagnosis of a cardiac tumor of origin is reached, which is why it is decided to hospitalize it. Control and stabilization of symptoms of cardiac pathology is carried out; transfer to a unit of greater complexity is decided by high probability of surgical resolution. Due to the risks involved in the surgical approach. high susceptibility to survival intra and postoperative family decide not to perform any invasive process despite having received information about the benefits It is not possible to carry out excess of the tumor, consequently it is not possible to determine its histopathological origin. However, due to risk factors, clinical characteristics and echocardiography presented, it is inferred subjectively that the cardiac tumor may be of possibly myxomatous origin. It is considered necessary to identify risk factors, clinical manifestations, diagnostic, therapeutic complexities, prognosis and complications of cardiac tumors of probable myxomatous etiology to predict their unfavorable evolution and mortality