RT Book, Section A1 Kiefer, Todd A1 Granger, Christopher B. A1 Jackson, Kevin P. A2 Papadakis, Maxine A. A2 McPhee, Stephen J. A2 Rabow, Michael W. A2 McQuaid, Kenneth R. SR Print(0) ID 1193148401 T1 Primary Cardiac Tumors T2 Current Medical Diagnosis & Treatment 2023 YR 2023 FD 2023 PB McGraw-Hill Education PP New York, NY SN 9781264687343 LK accessmedicine.mhmedical.com/content.aspx?aid=1193148401 RD 2024/11/02 AB Primary cardiac tumors are rare and constitute only a small fraction of all tumors that involve the heart or pericardium. The most common primary tumor is atrial myxoma; it comprises about 50% of all tumors in adult case series. It is generally attached to the atrial septum and is more likely to grow on the LA side of the septum rather than the RA. Patients with myxoma can rarely present with the characteristics of a systemic illness, with obstruction of blood flow at the mitral valve level, or with signs of peripheral embolization. The syndrome includes fever, malaise, weight loss, leukocytosis, elevated ESR, and emboli (peripheral or pulmonary, depending on the location of the tumor). This is sometimes confused with infective endocarditis, lymphoma, other cancers, or autoimmune diseases. In most cases, the tumor may grow to considerable size and produce symptoms by simply obstructing mitral inflow. Episodic pulmonary edema (classically occurring when an upright posture is assumed) and signs of low output may result. Physical examination may reveal a diastolic sound related to motion of the tumor (“tumor plop”) or a diastolic murmur similar to that of mitral stenosis (AUDIO 10–18). Right-sided myxomas may cause symptoms of right-sided failure. Familial myxomas occur as part of the Carney complex, which consists of myxomas, pigmented skin lesions, and endocrine neoplasia.