• Qiushuang Wang, Feifei Yang, Fei Zhu, and Cunshan Yao.
• Department of Cardiology.
• Medicine (Baltimore). 2018 Dec 1; 97 (51): e13451.

RationaleLeft atrial myxoma is a common primary cardiac tumor, however, due to poor image quality or atypical myxoma images, it is often misdiagnosed by echocardiograph. A case of left atrial myxoma being misdiagnosed as a thrombus, which successively caused acute myocardial infarction (AMI) and stroke, is very rare. Contrast-enhanced echocardiography can play an important role in definitive diagnosis.Patient ConcernsA 44-year-old woman was diagnosed AMI because of chest pain with no significant stenosis in the coronary arteries. One month later, the patient was suddenly found unconscious, magnetic resonance imaging (MRI) showed acute multiple cerebral infarctions in the left cerebral hemisphere.DiagnosesLeft atrial myxoma, acute myocardial infarction, and stroke.InterventionsThe patient was given a cardiac surgery for tumor resection, the mass was surgically removed and histopathologic findings showed myxoma.OutcomesAfter several weeks of rehabilitation, the patient was able to resume daily activities without chest discomfort or dyspnea. One year later, echocardiography showed no recurrence of left atrial myxoma. The patient generally was in good condition.LessonsAlthough myxoma is mostly benign, this patient occurred AMI and stroke because of misdiagnosis. Comprehensive assessments should be performed with multiple imaging methods for cardiac masses. If necessary, contrast-enhanced echocardiography should be used to clarify, so as not to delay the timing of surgery and bring potential risk of death to patients.

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