• Guofeng Ma, Dan Wang, Yongtao He, Ruifeng Zhang, Yong Zhou, and Kejing Ying.
• Department of Respiratory Diseases.
• Medicine (Baltimore). 2019 Dec 1; 98 (51): e18386e18386.

RationalePulmonary embolisms (PEs) are caused by emboli, which mostly originate from deep venous thrombi that travel to and suddenly block the pulmonary arteries. The emboli are usually thrombi, and right atrial myxoma emboli are rare.Patient ConcernsA 55-year-old man presented with shortness of breath and syncope. We proceeded with computed tomography pulmonary angiography (CTPA) and transthoracic echocardiogram (TTE), the results of which suggested that the diagnosis was a right atrial mass.DiagnosisA definitive diagnosis compatible with a right atrial myxoma (RAM) with tumoral pulmonary emboli after surgical excision was made.InterventionRight atrial and pulmonary artery embolectomy.OutcomesThe patient followed an uneventful course during the 6 years of follow-up after surgery. According to a review of the literature, RAMs are often not diagnosed in a timely manner or even go completely undiagnosed. TTE, transesophageal echocardiography (TEE), CT, magnetic resonance imaging (MRI), and positron emission tomography/computed tomography may be helpful in the preoperative diagnosis. Surgical removal of the masses from the atrium and pulmonary arteries was relatively uneventful.LessonsRAMs should be considered unlikely reasons for fatal pulmonary embolisms.

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