Giant obstructive left atrial myxoma resembling mitral valve stenosis

Primary tumors of the heart are rare, with an incidence between 0.0017% and 0.19% in unselected patients at autopsy. Approximately 75% of the tumors are benign, and nearly half of them are myxomas (1). Atrial myxoma is the most common benign cardiac neoplasm, and its origin has been ascribed to a multipotential mesenchymal cell (2). Myxomas commonly occur between the third and sixth decades of life and are three times more frequent in women (3). There are two distinctive forms of the tumors: solid and ovoid myxomas and soft and papillary myxomas. Solid tumors are more likely to present with symptoms of congestive heart failure (CHF), while papillary tumors are more likely to embolize to the cerebral and other peripheral vessels (4). At the time of diagnosis, 92% of the patients have symptoms of CHF (5). Atrial myxoma may mimic valvular heart disease, cardiac insufficiency, cardiomegaly, bacterial endocarditis, disturbances of ventricular and supraventricular rhythm, syncope, and systemic or pulmonary embolism (3). The purpose of this paper is to present a case report of atrial myxoma mimicking severe mitral valve stenosis at cardiac auscultation and the importance of echocardiograpy in the diagnosis.