Hemodynamic Collapse Due to Leiomyosarcoma: Intracardiac Obstruction as a Trigger for Multiorgan Dysfunction

We present a malignant intracardiac tumor causing hemodynamic collapse and multiorgan dysfunction. The uncommon clinical presentation included progressive dyspnea associated with recurrent pleural effusions, initially approached as rheumatologic disease due to renal failure, serositis, anemia, and thrombocytopenia. The patient experienced positional syncope, biventricular cardiogenic shock, severe jugular distension, collateral circulation, edema, and pulmonary congestion requiring advanced life support. Echocardiography revealed a myxoid mass in the left atrium protruding through the mitral valve, significantly affecting cardiac function. Surgical resection achieved temporary remission, with histopathology confirming epithelioid leiomyosarcoma. However, prognosis remains poor due to high recurrence and therapeutic resistance.