Giant Left Atrial Myxoma Presenting with Severe Pulmonary Hypertension

The etiology of cardiac tumors has a broad differential diagnosis. The use of a multidisciplinary team along with appropriate workup with multimodality imaging is critical for patient management. A 41-year-old man with a history of heavy tobacco use presented with abdominal distension, edema, and dyspnea for the past month. Prior to this presentation, he had experienced two episodes of right upper extremity and left lower extremity paresthesias that resolved spontaneously. A chest computed tomography (CT scan revealed an 8.5 cm mass that obliterated the left atrium and protruded across the mitral valve. Multimodal imaging (transthoracic echocardiography and cardiac MRI) confirmed a diagnosis of myxoma. Highlighting the severity of the presentation, hemodynamics revealed severe pulmonary hypertension. The patient underwent surgical resection with complete resolution of symptoms. Atrial myxomas are rare, but are among the most common type of benign cardiac tumors. Prompt optimization and definitive surgical management are critical.