Coronary Artery Embolism Associated with LA Myxoma: A Very Rare but Potentially Dangerous Entity

We describe the case of a 52-year-old male patient who presented with acute anterior MI in another center and was subsequently referred to our department because of an LA mass. Echocardiography data revealed a large mobile mass in the mitral annulus without attachment to the IAS. Angiography data showed that the LAD was totally cut off after the first large diagonal branch with poor run off. Emergent surgical procedures and pathological studies of the mass revealed a myxoma of the LA in an unusual position and coronary artery embolism due to myxoma. Intracardiac myxomas are the most frequent benign tumors of the heart. While most cases are located in the left atrium, myxomas are also found in the right atrium (18 percent), right ventricle (4 percent) and left ventricle (4
percent). Cardiac myxomas usually originate from the region of the fossa ovalis, but may arise from a variety of locations within the atria. Although myxomas have been reported as originating from the mitral annulus, the mitral valve itself, the aortic valve, and the inferior vena cava, coronary artery embolism associated with myxoma is very rare
and has been documented by both angiography in living patients and histology at post mortem study. Myocardial infarction is sometimes the first manifestation of a myxoma1