Resumo
Definition
O mixoma é o tumor cardíaco mais comum e constitui 50% de todos os tumores cardíacos benignos em adultos, mas representa apenas 15% desses tumores em crianças. Cerca de 75% dos tumores cardíacos primários são benignos. A maioria dos mixomas é encontrada no átrio esquerdo (75%), e em frequências decrescentes no átrio direito, no ventrículo direito e no ventrículo esquerdo.[Figure caption and citation for the preceding image starts]: Grande mixoma atrial esquerdoDo acervo do Dr. Syed Wamique Yusuf, Departamento de Cardiologia, University of Texas, MD Anderson Cancer Center; usada com permissão [Citation ends].
[Figure caption and citation for the preceding image starts]: Plano macroscópico de mixoma atrial esquerdoR Al-Shahi Salman, D Northridge, ANJ Graham, R Grant. BMJ Case Reports 2009; doi:10.1136/bcr.09.2008.0875 [Citation ends].
History and exam
Key diagnostic factors
- presença de fatores de risco
- dispneia
- síncope
- tontura
- insuficiência cardíaca congestiva (ICC)/edema pulmonar
- manifestações embólicas
- sopro sistólico ou diastólico
- "plop" do tumor
Other diagnostic factors
- perda de peso
- fadiga
- febre
- palidez
- artralgia
- Fenômeno de Raynaud
- primeira bulha cardíaca hiperfonética
- estalido de abertura
- Complexo de Carney
- aneurisma intracerebral
Risk factors
- história familiar de mixoma atrial
- sexo feminino
- idade de 40-60 anos
Diagnostic investigations
1st investigations to order
- ecocardiograma
- eletrocardiograma (ECG)
- Hemograma completo
- radiografia torácica
Investigations to consider
- velocidade de hemossedimentação
- proteína C-reativa
- eletroforese de proteínas
- tomografia computadorizada (TC) do tórax
- ressonância nuclear magnética (RNM) do tórax
- biópsia
Treatment algorithm
candidato à cirurgia
não candidato à cirurgia
Contributors
Authors
Syed Wamique Yusuf, MBBS, FRCPI
Professor of Medicine
Department of Cardiology
University of Texas MD Anderson Cancer Center
Houston
TX
Disclosures
SWY declares that he has no competing interests.
Acknowledgements
Dr Syed Wamique Yusuf would like to gratefully acknowledge the assistance of Dr Daniel J. Lenihan.
Disclosures
DJL declares that he has no competing interests.
Peer reviewers
Paul Heidenreich, MD
Associate Professor of Medicine
Stanford University
Stanford
CA
Disclosures
PH declares that he has no competing interests.
Richard Steingart, MD
Chief
Cardiology Service
Memorial Sloan-Kettering Cancer Center
New York
NY
Disclosures
RS declares that he has no competing interests.
Barry Kneale, MD, FRCP
Integrated Lead Cardiologist
Western Sussex Hospitals NHS Trust and Cardiac Department
Worthing Hospital
Worthing
UK
Disclosures
BK declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Pinede L, Duhaut P, Loire R. Clinical presentation of left atrial cardiac myxoma. A series of 112 consecutive cases. Medicine (Baltimore). 2001 May;80(3):159-72. Abstract
Edwards A, Bermudez C, Piwonka G, et al. Carney's syndrome: complex myxomas. Report of four cases and review of the literature. Cardiovasc Surg. 2002 Jun;10(3):264-75. Abstract
Grossniklaus HE. McLean IW, Gillespie JJ. Bilateral eyelid myxomas in Carney's complex. Br J Ophthalmol. 1991 Apr;75(4):251-2.Full text Abstract
Ohara N, Komiya I, Yamauchi K, et al. Carney's complex with primary pigmented nodular adrenocortical disease and spotty pigmentations. Intern Med. 1993 Jan;32(1):60-2.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Estenose mitral
- Endocardite infecciosa
- Trombo atrial
More Differentials
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