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MYXOMA Cardiac myxomas are rare benign slow growing primary cardiac tumors found most commonly in the septum of the left atrium although they can occur in any chamber of the heart1234 Myxomas account for about 50 of all benign intercardiac tumors making them the most common1415161718 Approximately 70-85 of myxomas occur in the left atrium and the remainder in the right atrium1257910111213141617 Very rarely one will occur in either ventricle12912131416 A very small percentage 10 or less of myxomas are considered hereditary16791017 Hereditary myxomas typically occur in men in their 20s16 Non-hereditary myxomas most often occur in women between the ages of 30 and 6061015 Myxomas can appear white gray yellow brown or green and can range from 1 cm to 15 cm in size1316 with the average size being 5-6 cm13 The tumor itself can either be gelatinous with a lobular surface or more like a firm round mass732 The tumor is quite vascular and may be coated with thrombi15 About 30-50 of patients experience embolization to the brain kidneys eyes or extremities4717 The left atrial myxomas often arise from the upper portion of the septum and may prolapse through the mitral valve during diastole27 Although most myxomas are attached to the septum they may also be attached to the walls of the heart chamber or the valves1417 The tumors develop from the endocardium13 are attached to the wall by a short broad-based attachment called a stalk and swing freely within the cardiac chamber612 The freely moving tumor may then intermittently block the mitral valve obstructing blood flow this mimics mitral stenosis610 When the patients stands up gravity can also pull the myxoma into the opening of the mitral valve blocking blood flow into the ventricle6 Mitral regurgitation may occur if the tumor prolapses through the valve and prevents proper valve closure7 Many of the other symptoms are vague and some patients may not experience ANY symptoms4 Possible symptoms include12456 Approximately 30-50
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