Skip to content
DraconiticResearch
Search Sources API
181,716 studies31 sourcesUpdated 3 min ago
Peer-reviewedCC BYMajalah Kardiologi Indonesia

Obstructive Giant Left Atrial Myxoma Concurrent with Very High-Risk Acute Coronary Syndrome Presenting as Cardiogenic Shock: A Rare Dual Pathology

  • Muhammad Rizky Felani1
  • Maria Lerista2
  • Sandy Hasan3
  • Aswin Nugraha4
  • Andina Dewanty5
5 affiliations
  1. 1Cardiologist, Department of Cardiology and Vascular, Mohammad Hoesin General Hospital/Department of Cardiology and Vascular, Hermina Hospital, Palembang, Indonesia
  2. 2Research Assistant, Department of Cardiology and Vascular, Mohammad Hoesin General Hospital Palembang
  3. 3General Practitioner, Hermina Hospital, Palembang, Indonesia
  4. 4Cardiothoracic and Vascular Surgeon, Department of Cardiovascular, Thoracic and Vascular, Mohammad Hoesin General Hospital, Palembang, Indonesia
  5. 5Cardiothoracic and Vascular Resident, Department of Cardiovascular, Thoracic and Vascular, Mohammad Hoesin General Hospital, Palembang, Indonesia
Read full textPDFDOICite

Abstract

Background: Primary cardiac tumors are exceptionally rare, with cardiac myxomas being the most common benign type, typically originating in the left atrium. Despite their benign histopathological nature, these tumors can lead to serious complications, including intracardiac obstruction, embolic events, and even sudden cardiac death. The coexistence of a Left Atrial (LA) myxoma and Coronary Artery Disease (CAD) is an unusual clinical finding. This report highlights the importance of recognizing cardiac myxoma as a potential contributor to high-risk acute coronary syndrome and hemodynamic instability.

Case Illustration: A 57-year-old man presented with recurrent chest pain and shortness of breath, consistent with very high-risk Non–ST Elevation Myocardial Infarction (NSTEMI) and cardiogenic shock. Transthoracic Echocardiography (TTE) revealed a large LA mass causing functional mitral valve obstruction, highly suggestive of a myxoma. Further evaluation with transesophageal echocardiography confirmed a giant, highly mobile mass intermittently occluding the mitral inflow. Coronary angiography revealed significant Two-Vessel Coronary Artery Disease (CAD2VD), including chronic total occlusion of the Left Circumflex Artery (LCx). The patient subsequently underwent urgent combined surgical excision of the tumor and Coronary Artery Bypass Grafting (CABG). Histopathological examination confirmed the diagnosis of cardiac myxoma. The postoperative course was uneventful, with marked clinical improvement, complete resolution of symptoms, and preserved ventricular function on follow-up echocardiography.

Conclusions: This case of very high-risk NSTEMI with cardiogenic shock was further complicated by a large LA myxoma causing dynamic mitral obstruction and diastolic inflow collapse. Early recognition using multimodal imaging and prompt surgical management are essential to prevent catastrophic hemodynamic deterioration and improve patient outcomes.

Related

  1. Myocardial Infarction with Non-obstructive Coronary Arteries; Diffuse Large B-Cell Lymphoma Presenting as an Acute Coronary Syndrome.
    Rahul Vilas Deshpande, Gregory Milne Aroney, Teng Fong Ng +2
    Archives of academic emergency medicinePeer-reviewedCC BY-NCFull textCardiovascular medicineEurope PMC
  2. Sudden Cardiac Arrest in a Previously Healthy Young Male: Perimyocarditis Presenting as Myocardial Infarction With Non-obstructive Coronary Arteries.
    Marco Antonio Rodríguez Sánchez, Victor Emmanuel Gonzalez Zazueta, Luis David Beltrán Ontiveros +4
    CureusPeer-reviewedCC BYFull textCardiovascular medicineEurope PMC
  3. Large Obstructive Left Atrial Myxoma in an Adolescent Girl Presenting With Stroke
    Cyndee Jocson, Alexander Dahl, Stefanie Cheang
    Clinical case reportsPeer-reviewedCC BY-NC-NDFull textGeneral medicineEurope PMC
  4. Spontaneous Bilateral Vesical Artery Pseudoaneurysms Presenting With Massive Recurrent Hematuria and Obstructive Acute Kidney Injury: A Case Report
    Dheeraj Kumar Alias Sailish, Amisha Kumari, Hadia Jamil +4
    Clinical case reportsPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  5. Capillary hemangioma of the breast presenting as a new mass on screening mammography: A case report with imaging-pathology correlation
    Romuald Ferre, Anne Bartels, Cherie M. Kuzmiak
    Radiology case reportsPeer-reviewedCC BYFull textGeneral medicineEurope PMC

Cite

BibTeXRIS
BibTeX
@article{felani2026obstructive,
  title = {{Obstructive Giant Left Atrial Myxoma Concurrent with Very High-Risk Acute Coronary Syndrome Presenting as Cardiogenic Shock: A Rare Dual Pathology}},
  author = {Muhammad Rizky Felani and Maria Lerista and Sandy Hasan and Aswin Nugraha and Andina Dewanty},
  journal = {Majalah Kardiologi Indonesia},
  year = {2026},
  month = oct,
  doi = {10.30701/ijc.2078},
  url = {https://doi.org/10.30701/ijc.2078},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Obstructive Giant Left Atrial Myxoma Concurrent with Very High-Risk Acute Coronary Syndrome Presenting as Cardiogenic Shock: A Rare Dual Pathology
AU  - Muhammad Rizky Felani
AU  - Maria Lerista
AU  - Sandy Hasan
AU  - Aswin Nugraha
AU  - Andina Dewanty
PY  - 2026
DA  - 2026/10/25
JO  - Majalah Kardiologi Indonesia
DO  - 10.30701/ijc.2078
UR  - https://doi.org/10.30701/ijc.2078
AB  - Background: Primary cardiac tumors are exceptionally rare, with cardiac myxomas being the most common benign type, typically originating in the left atrium. Despite their benign histopathological nature, these tumors can lead to serious complications, including intracardiac obstruction, embolic events, and even sudden cardiac death. The coexistence of a Left Atrial (LA) myxoma and Coronary Artery Disease (CAD) is an unusual clinical finding. This report highlights the importance of recognizing cardiac myxoma as a potential contributor to high-risk acute coronary syndrome and hemodynamic instability.  Case Illustration: A 57-year-old man presented with recurrent chest pain and shortness of breath, consistent with very high-risk Non–ST Elevation Myocardial Infarction (NSTEMI) and cardiogenic shock. Transthoracic Echocardiography (TTE) revealed a large LA mass causing functional mitral valve obstruction, highly suggestive of a myxoma. Further evaluation with transesophageal echocardiography confirmed a giant, highly mobile mass intermittently occluding the mitral inflow. Coronary angiography revealed significant Two-Vessel Coronary Artery Disease (CAD2VD), including chronic total occlusion of the Left Circumflex Artery (LCx). The patient subsequently underwent urgent combined surgical excision of the tumor and Coronary Artery Bypass Grafting (CABG). Histopathological examination confirmed the diagnosis of cardiac myxoma. The postoperative course was uneventful, with marked clinical improvement, complete resolution of symptoms, and preserved ventricular function on follow-up echocardiography.  Conclusions: This case of very high-risk NSTEMI with cardiogenic shock was further complicated by a large LA myxoma causing dynamic mitral obstruction and diastolic inflow collapse. Early recognition using multimodal imaging and prompt surgical management are essential to prevent catastrophic hemodynamic deterioration and improve patient outcomes.
SN  - 0126-3773
SN  - 2620-4762
ER  -