An atrial myxoma is a noncancerous tumor in the upper left or right side of the heart. It grows on the wall that separates the two sides of the heart. This wall is called the atrial septum.

Symptoms may occur at any time, but most often they go along with a change in body position.

Symptoms of a myxoma may include:

• Breathing difficulty when lying flat
• Breathing difficulty when asleep
• Chest pain or tightness
• Dizziness
• Fainting
• Sensation of feeling your heart beat (palpitations)
• Shortness of breath with activity

The symptoms and signs of left atrial myxomas often mimic mitral stenosis. Right atrial myxomas rarely produce symptoms until they have grown to be at least 5 inches wide.

Other symptoms may include:

• Blueness of skin, especially the fingers (Raynaud's phenomenon)
• Cough
• Curvature of nails accompanied with soft tissue swelling (clubbing) of the fingers
• Fever
• Fingers that change color upon pressure or with cold or stress
• General discomfort (malaise)
• Losing weight without trying
• Joint pain
• Swelling - any part of the body

The doctor or nurse will perform a physical exam and listen to your heart using a tool called a stethoscope. Abnormal heart sounds or a murmur may be heard. These sounds may change when you change body position.

Imaging tests may include:

• Chest x-ray
• CT scan of chest
• ECG
• Echocardiogram
• Doppler study
• Heart MRI
• Left heart angiography
• Right heart angiography

Blood tests:

A complete blood count may show anemia and increased white blood cells. The erythrocyte sedimentation rate (ESR) is increased.

Surgery is needed to remove the tumor. Some patients will also need their mitral valve replaced. This can be done during the same surgery.

Myxomas may come back if surgery did not remove all of the tumor cells.

Although a myxoma is not cancer, complications are common.

Untreated, a myxoma can lead to an embolism (tumor cells breaking off and traveling with the bloodstream), which can block blood flow or cause the tumor to grow in another part of the body. Pieces of the tumor can move to the brain, eye, or limbs.

If the tumor grows inside the heart, it can block blood flow. This may require emergency surgery to prevent sudden death.

• Arrhythmias
• Pulmonary edema
• Peripheral emboli
• Spread (metastasis) of the tumor
• Blockage of the mitral heart valve

McManus B. Primary tumors of the heart. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap74.

McKenna W. Diseases of the myocardium and endocardium. In:Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 60.