Case description
A 67-year-old female with a history of diabetes and hypertension was admitted to the coronary care unit due to dyspnea associated with dizziness, intermittent holocranial headache (Verbal Pain Intensity Scale 3/10), cough, and stabbing chest pain that had begun three years prior. Dyspnea had evolved from grade I to IV on the New York Heart Association (NYHA) Scale in a one month period, after which she consulted her physician, who referred her to the cardiologist after ordering an anteroposterior chest-x ray that showed left cardiomegaly. An apex beat was found on the 5th left intercostal space with a split second sound secondary to a tumor plop. Follow-up transthoracic echocardiogram (TTE) was performed, showing a mobile, regular edged 59 x 49 mm LA mass with a thin peduncle attachment to the atrial septum, that protruded towards the left ventricle during diastole. An electrocardiogram was performed, showing sinus rhythm with a slight left axis deviation. (Figure 1) Subsequent Transesophageal Echocardiography (TEE) was performed, observing a mass in the LA.(Figure 2) Surgical removal of the mass was performed successfully, and the patient recovered fully after a few days. Histopathologic analysis showed characteristic mucoid degeneration with stellate cells (Figure 3) , thus confirming the diagnosis of a left atrial myxoma that correlated in shape and size to the mass observed through transillumination echocardiography (Figure 4) . Follow-up TTE showed the absence of the mass with an adequately functioning mitral valve and left ventricle.