Atrial myxoma as a complication of tocolytic therapy. A case report.
A 27-year-old woman who presented with premature labor was given ritodrine for tocolysis. During the administration of the beta-sympathomimetics she developed cardiac changes, including subendocardial ischemia on EKG and an intermittent early diastolic sound. Echocardiography revealed a large left atrial myxoma. It was removed during pregnancy, and the patient tolerated the procedure well. The mechanism of the ischemia was believed to result from the space-occupying mass of the myxoma, preventing adequate atrial filling and subsequent congestive failure. It is recommended that patients who develop cardiac symptoms during tocolysis with beta-sympathomimetics undergo further investigation to rule out under-lying pathology.
D000328:Adult; D005260:Female; D006325:Heart Atria; D006338:Heart Neoplasms / Q000175:diagnosis*; D006801:Humans; D009232:Myxoma / Q000175:diagnosis*; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis*; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis*; D011412:Propanolamines / Q000009:adverse effects*; D012312:Ritodrine / Q000009:adverse effects*
D011412:Propanolamines; D012312:Ritodrine