A case report of recurrent syncope & transient ischaemic attack in elderly man

Intracardiac myxoma is the most frequent benign tumour of the heart. Although most (75%) are located in the left atrium (LA), myxomas are also found in the right atrium (18%), right ventricle (4%), and left ventricle (3%).They occur in all age groups, most frequently between third and sixth decade, while it is rare in the ninth decade [1,2]. Left atrial myxoma(LAM) is histologically benign and is the most common primary tumour of the heart [3]. It accounts for 80% of all cardiac tumours [4]. Differential diagnosis of atrial myxoma includes pedunculated thrombus, metastatic sarcoma and melanoma in left atrium [3]. Atrial myxoma in older people is considered to be unusual, but with the advent of newer imaging modalities and longer life expectancy, the incidence of myxoma in older has increased [1]. Atrial myxoma may be asymptomatic, in contrast, symptomatic cases may present with obstruction of cardiac blood flow, embolic phenomena and constitution symptoms. Common symptoms include chest pain, dyspnea, orthopnea, peripheral embolism or syncope [2,5,6]. Left atrial myxoma (LAM), if left untreated, is inexorably progressive and usually fatal. It is an important source of central nervous system embolisom and producing TIA as an initial neurological manifestation before producing cardiac symptom in some cases [7].