A Case of Infected Left Atrial Myxoma Presenting as ST-Elevation Myocardial Infarction (STEMI)
| Autor: | Matthew Peters, Michel G. Farah, Khaled W. Tuwairqi |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Acute coronary syndrome medicine.medical_treatment 030204 cardiovascular system & hematology Transesophageal echocardiogram Coronary Angiography Diagnosis Differential Heart Neoplasms Electrocardiography 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Streptococcal Infections Internal medicine Mitral valve Humans Medicine cardiovascular diseases Myocardial infarction Acute Coronary Syndrome Cardiac Surgical Procedures medicine.diagnostic_test business.industry Coronary Thrombosis Ceftriaxone Mitral valve replacement Streptococcus Myxoma Articles General Medicine medicine.disease Anti-Bacterial Agents medicine.anatomical_structure 030220 oncology & carcinogenesis cardiovascular system Cardiology ST Elevation Myocardial Infarction Gentamicins Left Atrial Myxoma business Echocardiography Transesophageal |
| Zdroj: | The American Journal of Case Reports |
| ISSN: | 1941-5923 |
| DOI: | 10.12659/ajcr.918192 |
| Popis: | Patient: Male, 34-year-old Final Diagnosis: Infected atrial myxoma Symptoms: Chest pain Medication: — Clinical Procedure: — Specialty: Cardiology Objective: Rare disease Background: Although left atrial myxoma is the most common benign primary cardiac tumor, infected atrial myxoma is rare. This report presents a case of infected left atrial myxoma with embolization to the left anterior descending (LAD) coronary artery, which was identified following an initial presentation with ST-elevation myocardial infarction (STEMI). Case Report: A 34-year-old man with a history of smoking tobacco and intravenous cocaine use presented to the emergency room with symptoms of a feeling of pressure on the chest and symptoms in the left arm. An electrocardiogram (ECG) showed ST elevation in leads II, III, aVF, and V3–V5, consistent with an anterior-inferior STEMI. He underwent percutaneous intervention (PCI) with two drug-eluting stents to the mid-distal LAD coronary artery. The patient also had fever, chills, a history of weight loss, and signs of peripheral emboli. Blood cultures identified Gram-positive Streptococcus parasanguinis, a member of the Streptococcus viridans group. Transesophageal echocardiogram (TEE) identified a large, mobile, pedunculated left atrial mass protruding into the mitral valve in diastole and mitral valve vegetations. Surgical excision and the histology confirmed a diagnosis of benign left atrial myxoma containing Gram-positive cocci. The patient required mitral valve replacement and a postoperative two-week course of gentamicin and a six-week course of ceftriaxone Conclusions: A rare case is reported of infected left atrial myxoma presenting as STEMI secondary to coronary artery embolization, which was treated with PCI, antibiotics, and mitral valve replacement. |
| Databáze: | OpenAIRE |
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