9 procedures for diagnosing myxoma of the heart

Cardiac myxoma is a benign tumor that occurs in half of all detected neoplasms in the myocardium. Pathology is diagnosed in women 3 times more often than in male patients. The age of patients with myxoma is from 40 to 60 years.

The exact causes of the appearance of the tumor cannot be determined, which makes treatment difficult. Heredity is one of the factors provoking the development of myxoma. Based on the clinical picture and diagnosis, the cardiologist determines the localization of the tumor and proceeds to treatment.

Characteristic

There are two versions of the possible origin of myxoma. Some scientists are considering the option of degeneration of a parietal thrombus. Other experts insist on the primary nature of education, paying attention to the possibility of myxoma particles to get to different places in the body, developing there.

• transparent jelly-like substance, not very dense, firmly attached to the wall of the myocardium;
• a tumor of a round shape, high density, with a small stalk attached to the wall of the heart.

Both variants of myxoma have a smooth surface. Developing, the tumor changes its structure, becomes hard, ossifies. Due to the fragile structure, small areas of education come off, an embolism process occurs.

The size of neoplasms is different, depending on the age of the tumor and the degree of development. Doctors identified myxomas from 1 to 10 cm. At the initial stage, the tumor does not harm the body, there are no symptoms indicating the presence of education.

Increasing in size, changing its structure and breaking into pieces that can clog blood vessels, the tumor becomes a threat to the patient's life. Timely surgery reduces the risk of complications and death.

The tumor can develop in different parts of the myocardium:

1. In most cases (75%), left atrial myxoma is diagnosed. It reduces the mitral orifice due to interruptions in blood supply. The pressure rises, hypertension develops, heart failure.
2. The appearance of a tumor in the right atrium is observed in 15-20% of cases. Education causes disruption of the venous outflow, blocking access. Fluid accumulates in the tissues, pleurisy, edema, and ascites occur.
3. Myxoma in the ventricles is a rare pathology (5-7% of cases). It is characterized by severe symptoms of obstructive cardiomyopathy: shortness of breath, heart pain, fainting.

Tumors can appear simultaneously in different parts of the myocardium. They are able to move along the wall from one part of the heart to another. Myxoma is constantly growing, without surgical intervention the problem will not disappear.

Causes and risk factors

Medicine does not name the exact causes of the development of myxoma of the heart muscle.

1. Hereditary (family) character. 7-10% of cases of the appearance of a tumor is associated with heredity.
2. Carney's syndrome is the presence of a large number of benign formations on different organs.
3. Increased load on the heart (physical, emotional reasons).
4. Anomalies of a genetic nature.
5. Myocardial damage (mechanical causes, falls).
6. Conducting a transseptal puncture.
7. Possible injuries during operations on the mitral valves.

• women;
• people after 40 years;
• cancer patients;
• people who have relatives with this pathology.

To detect a tumor at an early stage, it is necessary to undergo regular medical examinations. Examinations show the patient's condition, indicate the development of deviations from the norm.

Symptoms

The initial stage of tumor development does not show any signs. As the myxoma grows in size, symptoms appear. They are permanent or occur from time to time - everything is individual in each case.

Patients complain of embolic and obstructive disorders. Also, the symptoms may depend on the characteristics of the human constitution (body build, mental and physiological state).

• sharp pain in the chest, not amenable to relief with medications;
• frequent cases of loss of consciousness;
• respiratory failure, severe shortness of breath for no apparent reason;
• decrease in the level of platelets;
• dizziness;
• an increase in the frequency of myocardial contractions (tachycardia) at rest;
• increased blood pressure;
• anemic processes;
• the presence of heart murmurs, which vary depending on the position of the patient;
• significant weight loss;
• bouts of nausea;
• features of the Raynaud phenomenon (increase in the sensitivity of the fingertips, change in their color);
• fever (37-37.5);
• the presence of edema;
• muscle pain;
• coughing fits, possible with the release of blood;
• fatigue, weakness;
• rash on the skin.

The appearance of any of these signs requires a visit to the doctor. Early detection of myxoma increases the chances of effective treatment.

Diagnostic methods

To determine the presence of a tumor of the heart muscle, its size and localization, the doctor conducts a comprehensive examination.

1. Listening to heart sounds with a stethoscope. The cardiologist draws attention to the change in myocardial tones with a change in body position. If the tumor is in the left atrium, there is an increase in systolic stroke. Violation of diastolic tone indicates myxoma of the left ventricle.
2. Electrocardiography (ECG) detects abnormal heart rhythms. The cause of the violations is vasoconstriction. Stenosis is caused by various diseases of the cardiovascular system. The exact diagnosis of the ECG will not help determine.
3. Phonocardiography determines the presence of all heart sounds and abnormalities. A tumor that has blocked the left atrium will reduce access to the mitral valve, and there will be no tone of its opening.
4. Echocardiography is considered the most informative way to diagnose myxoma. The smooth surface of the tumor gives a distinct echo signal, which allows you to determine the location and size of the formation. Transesophageal diagnostics is often used, it is more informative, especially before a surgical operation.
5. X-ray diagnostics determines changes in the structure of the myocardium. Ossification of the tumor indicates the late stages of pathology.
6. Examination of the heart using ultrasound reveals an echogenic mass, indicating the presence of a foreign body. This may be a thrombus, it is necessary to conduct a differential diagnosis.
7. Angiography using contrast injected through the vessels. Observation is carried out under x-ray, the results are visible in the photo.
8. Computed tomography determines the size and location of the formation, indicates possible changes in adjacent tissues.
9. Magnetic resonance imaging is used on the eve of the operation to see how deep the tumor is, what structural changes have occurred.

You can confuse a benign formation with such pathologies:

• malignant tumors (lipomas, teratomas);
• collagenosis;
• pulmonary hypertension as the primary focus;
• infectious myocarditis;
• stenoses of the heart (mitral, tricuspid);
• valvular insufficiency, reverse flow;
• pulmonary embolism.

If the diagnosis is confirmed, the doctor performs coronary angiography to determine the patency of the vessels. This examination is mandatory for patients over 45 years of age before making a decision on surgical intervention.

Treatment

Although myxoma is a benign tumor, it is located in the myocardium, increases in size and causes dangerous complications of the cardiovascular system. Therefore, when a patient turns to a cardiologist with symptoms indicating a tumor, and diagnostic methods confirm this, it is necessary to remove the tumor.

Drug therapy and folk remedies reduce pain, but they do not affect education. Emergency surgery is the only correct treatment for myxoma.

Operation

Removal is carried out under general anesthesia.

1. Opens the sternum to have access to the myocardium.
2. Connects the patient to a heart-lung machine.
3. Makes an incision in the myocardium at the location of the formation.
4. Cuts off the tumor along the leg.
5. Eliminates defects in the myocardium, if necessary.
6. Sewing up the heart muscle.
7. Disconnects the patient from the device.

After the operation, constant monitoring of the patient's condition is necessary. Therefore, the patient is in the hospital for 17-10 days, in especially severe cases - about a month.

Complications

Unforeseen circumstances during surgery are caused by:

• insufficient preparation;
• hard-to-reach location of education;
• heart rhythm disturbances;
• myocardial infections.

In the postoperative period, the patient needs constant medical supervision.

After removal of the tumor, complications may develop:

• bleeding at the incision site;
• embolism due to damage to the arteries;
• various infections introduced during the removal of the myxoma;
• arrhythmia;
• hypertension.

Antibacterial therapy after surgery reduces the risk of complications. The patient receives the doctor's recommendations, following which will help to quickly restore good health.

Recovery and forecast

The recovery period is individual for each individual case. It depends on the age, the complexity of the operation, the characteristics of the body. According to statistics, patients after heart surgery return to a full life, start working after 2-2.5 months.

To improve the prognosis, it is necessary to follow the recommendations of the attending physician.

1. Get examined regularly.
2. To refuse from bad habits.
3. Reduce the possibility of stress.
4. Get enough sleep (>8 hours).
5. Protect yourself from injuries, chest bruises.
6. Eat well.
7. Take regular walks outdoors.
8. Avoid infectious patients.
9. Take a course of physical therapy after consulting a doctor.

After removal of the myxoma, the prognosis is good. Resection of the tumor removes all symptoms, and the patient returns to a normal rhythm of life. Statistical data indicate a lethal outcome during or after surgery in 5% of cases of formation in the atrium, 10% - tumors of the ventricle. If surgery is not used, the life expectancy of a patient with a tumor does not exceed 2 years after diagnosis.

The causes of cardiac myxoma have not been established, but risk factors are known that can be eliminated by adjusting lifestyle. Although the tumor is benign, the presence of symptoms of pathology requires urgent medical attention. An increase in education threatens the development of severe complications, a fatal outcome is possible. Differential diagnosis will distinguish myxoma from other similar diseases. Timely surgery will eliminate the symptoms, return the patient to normal life.