Myxoma is rare. Autopsy studies show about 100 myxoma per million people. They are more common in women than in men for reasons that are not well understood. The size at the time of diagnosis is variable. Most are egg-shaped, ranging in size from small beans and large grapefruits. These tumors, as in this case, are often found by chance with ultrasound ordered to look for something else. However, they cause symptoms and, in rare cases, even death.
Minera explained that it is important to know the anatomy to understand the harm. The heart is divided into four chambers — the right side of the heart receives oxygen-poor blood from the rest of the body. When the heart beats, the blood on the right side is pushed into the lungs, where it is refilled with oxygen. When the heart relaxes, its newly oxygenated blood flows to the left side of the heart. Both sides are divided into two parts. The atrium, the thin-walled chamber that receives the blood, and the more muscular ventricle that pushes the blood to the next stop, the lungs (from the right side) or the rest of the body. (From the left side). These tumors may have small blood clots on their surface. If the mass is on the left side of the heart (most often), loose blood clots can move to the brain and cause a stroke. If this patient’s mass is to the right of where it is seen, the blood clot moves to the lungs, where it blocks blood flow.
Less common, but more worrisome, was the possibility of an obstruction in the heart. When the heart is compressed with each beat, the mass is pushed toward the valve that separates the atrium from the ventricle. If it somehow closes the opening, blood cannot pass through. Minera explained that it was probably what happened to her at the beauty salon. The episode is most likely caused by this sudden loss of blood flow to the brain. And when she stumbled, she pushed the mass out of the valve and blood flow resumed. The myxoma appeared to be just the right size to close the opening. She was lucky that it didn’t happen more often.
Minera told the patient and her husband that the tumor would have to be removed as soon as possible. The risk is small but realistic. The surgery was done 3 days later. The surgeon had to make a large cut in the chest from the neck to the bottom of the sternum. Only then did he safely remove the tumor.
When the woman returned home, her friend Sandy came to see her. Sandy has been worried since the woman first explained what the ultrasound showed. When Sandy returned home from her funeral, she read about those tumors. So she called Minera’s office that afternoon. She wanted to make sure that her next funeral wasn’t for her friend.
