Rare Cause of Pacemaker Lead Interference: Tricuspid Valve Myxoma

Introduction: Primary tumors of the heart are a rare finding, and the most common benign tumors are cardiac myxomas, accounting for up to 80% of cases. They are of endocardial origin therefore the prevalence of myxomas in the atrial septum is highest. Among myxomas left atrial ones are the most common (75%), followed by right atrial ones (18%). Case Presentation: We present a case of a cardiac myxoma of the tricuspid valve with a very unusual clinical presentation of ventricular pacemaker leads interference. A 71-year-old male with history of chronic atrial fibrillation, acute coronary artery syndrome, heart failure with ICD-CRT(Implantable cardioverter Defibrillator-Cardiac Resynchronization Therapy) implantation and mitral regurgitation. A transthoracic echocardiogram showed a right atrial filamentous mass originating from the posterior leaflet of the tricuspid valve and causing inappropriate sensing of the ventricular pacemaker leads. He underwent resection of the mass which on pathology was revealed to be a cardiac myxoma. Conclusions: Cardiac masses are relatively rare findings and the clinical presentation is characterized by nonspecific signs and symptoms, such as embolism, dyspnea, pulmonary edema, fever, fatigue and weight loss, which lead to a wide differential diagnosis. It is crucial for clinicians to consider cardiac myxomas among the possible diagnoses. This case report described an unusual clinical presentation of cardiac myxomas.