A 50-year-old woman with hypertension and no symptoms.
In routine outpatient follow-up, a two-dimensional transthoracic echocardiogram (Eco2D) was requested, after auscultation of a systolic murmur III/VI at the aortic focus.
The 2D-echo revealed the existence of a mobile gradient within the left ventricle of 5.0 x 1.3 cm, adhered to the septum with a maximum LV outflow tract of 26 mmHg, suggesting calcification, which caused partial obstruction.
No additional tumors were observed in any other cardiac chamber and laboratory tests, chest X-ray and electrocardiogram were normal.
For a better evaluation of the intraventricular mass, three-dimensional echocardiography (3D-Eco) was performed, which allowed the identification of the multilobular morphology of the tumor, objectifying -ade- that occupied 65% of the LVOT.
To complement the evaluation, cardiac resonance (CR) was performed, which showed a tumor with isointense signal regarding myocardial tissue and a peduncle of 2 cm adhering to the upper third of the normal mitral septum septa.
No spontaneous contrast was observed in the inversion/recovery image after gadolinium administration.
Finally, the evaluation of the patient was complemented with multislice computed tomography of the heart (MCCT), which confirmed the existence of calcified tumor areas suspected in the 2D-Echo.
With the diagnosis of left ventricular myxoma, the patient underwent surgical resection of the tumor via aortic transvalvular approach, which included its anchorage base and subsequent implantation of a bovine pericardial patch.
The mitral valve and its subvalvular apparatus were normal.
Histopathological analysis of the tumor confirmed the diagnosis of myxoma.
