Diagnostically Challenging Cardiac Myxoma Presenting as Acute Myocardial Infarction.

BACKGROUND

Primary cardiac tumors are rare. Among them, myxomas are the most common, and clinical presentations can be variable.

CASE SUMMARY: A 31-year-old woman presented with sudden-onset chest pain and syncope. The electrocardiogram demonstrated self-terminating ventricular tachycardia and inferior ST-segment elevation. She was found to have a left atrial myxoma with embolization to the coronary arteries and underwent successful emergency resection.

DISCUSSION: The diagnosis of stress cardiomyopathy was ruled out by echocardiography. Angiography did show an abrupt change in vessel diameter between normal and diseased segments, which suggested type 2 spontaneous coronary artery dissection. However, the abnormal left atrial feeding vessel suggested an embolic phenomenon from a cardiac tumor.

TAKE-HOME MESSAGES: This case is an unusual presentation of an embolizing left atrial myxoma presenting as acute myocardial infarction in a young woman. This highlights the importance of including left atrial myxoma in the differential diagnosis of acute coronary syndrome in young female patients.