Giant Biatrial Myxoma Presenting as Constitutional Symptoms and Bivalvular Obstruction

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BACKGROUND: Simultaneous biatrial myxoma is an extremely rare form of primary cardiac tumor, which is often an acute life-threatening problem given its potential to cause simultaneous tricuspid and mitral valve obstructions. CASE SUMMARY: A 25-year-old woman presented with a history of persistent low-grade fever, 6 kg of weight loss, and progressive dyspnea for 6 months. Transthoracic echocardiography showed a large mass from the interatrial septum and right atrial wall originating from the left atrium. This giant tumor was causing severe tricuspid obstruction and severe narrowing of the mitral valve. There was evidence of associated pulmonary emboli on computed tomography and computed tomography pulmonary angiography as well. The patient underwent successful urgent surgical excision. DISCUSSION: This case describes the rare presentation of giant biatrial myxoma in the form of chronic systemic illness. It emphasizes the role of early cardiac imaging in young patients with unexplained constitutional symptoms and features of biventricular heart failure. TAKE-HOME MESSAGES: Giant biatrial myxoma is very rare and is life threatening. Prompt and definitive surgical resection results in good outcome and is the treatment of choice.

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