title: Biatrial myxoma and multiple organ infarctions combined with Leriche syndrome in a female patient.
abstract: BACKGROUND
  Multiple organ infarctions combined with Leriche syndrome due to embolic particles of myxoma are very rare. There is no definite guideline for immediate medical treatment.
  
  
  METHODS
  A 36-year-old married female was referred to the emergency department (ED) with severe pain of both lower extremities and gradual decreased mental status. Brain magnetic resonance imaging (MRI) and computed tomography angiography (CTA) revealed acute multiple organ infarctions including the brain, spleen, and bilateral kidneys combined with Leriche syndrome. To evaluate the embolic source, echocardiography was performed and it revealed biatrial myxoma. Because of the risk of progression in systemic embolic events, surgical excision and embolectomy were performed urgently. After the operation, renal function was recovered, and the pain of both limbs was relieved. However, the visual field defect due to the brain infarction remained. She was discharged uneventfully on the fourteenth postoperative day.
  
  
  CONCLUSIONS
  This was an extremely rare case of multiple organ infarctions combined with Leriche syndrome as the initial presentation of biatrial myxoma. The treatment of choice for myxoma is surgical excision, but the optimal timing of operations is still controversial in patients who have had recent neurological insults. Echocardiography was useful to clarify the diagnosis and decide on the proper treatment modality: surgical treatment or thrombolysis.
authors.forename: Seung Yeon
authors.initials: SY
authors.lastname: Min
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seungdong-Gu, Heangdang-Dong 17, 133-070 Seoul, South Korea. mdoim@hanyang.ac.kr.
authors.forename: Young-Hyo
authors.initials: YH
authors.lastname: Lim
authors.forename: Hyung Tak
authors.initials: HT
authors.lastname: Lee
authors.forename: Jinho
authors.initials: J
authors.lastname: Shin
authors.forename: Kyung-Soo
authors.initials: KS
authors.lastname: Kim
authors.forename: Hyuck
authors.initials: H
authors.lastname: Kim
mesh_terms: D000328:Adult; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006338:Heart Neoplasms / Q000150:complications* / Q000601:surgery; D006801:Humans; D007238:Infarction / Q000150:complications* / Q000601:surgery; D007925:Leriche Syndrome / Q000150:complications* / Q000601:surgery; D009232:Myxoma / Q000150:complications* / Q000601:surgery; D009360:Neoplastic Cells, Circulating