Total detachment of cardiac myxoma causing saddle embolization and mimicking aortic dissection.
A 51-year-old male presented with sudden onset lower abdominal pain followed by weakness of both legs. Examination revealed blood pressure of 220/130 mmHg, with a grade 2/6 systolic murmur audible at the apex of the heart, and absence of both femoral arterial pulses. Two-dimensional and transesophageal echocardiography showed no evidence of intracardiac tumor or dissection of the ascending and thoracic aorta. Moreover, an aortogram demonstrated total occlusion of the abdominal aorta just below the renal arteries. A myxomatous-like material occupying the abdominal aorta just above the bifurcation of the common iliac arteries was discovered during surgery. Histologic examination of the embolic material confirmed the diagnosis of myxomatous embolus. One year after the embolic episode, the patient was well and two-dimensional and transesophageal echocardiography revealed no evidence of residual intracardiac tumor.
Fang
Ber-Ren
BR
Division of Cardiology, Chang Gung Memorial Hospital, Keelung, Taiwan, Republic of China.
Chang
Chih-Ping
CP
Cheng
Chi-Wen
CW
Yang
Ning-I
NI
Shieh
Min-Chan
MC
Lee
Ning
N
D000784:Aortic Dissection / Q000175:diagnosis; D001012:Aorta, Abdominal / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D003937:Diagnosis, Differential; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D006338:Heart Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000150:complications*; D018365:Neoplasm, Residual