An unusual case of mesenteric ischemia in a patient with cardiac myxoma

Abstract

Symptoms related to peripheral embolism are experienced in 2%-15% of cases of cardiac myxoma. We present a rare case of a 54-year-old man admitted due to sudden abdominal pain. A computed tomography (CT) scan showed occlusion of the superior mesenteric artery (SMA). As the patient's response to support treatment was favorable, a non-invasive approach was adopted, with prescription of oral anticoagulation (OAC) therapy. Transesophageal echocardiography revealed a tumor in the left atrium. The cardiac mass was completely removed and diagnosed as myxoma by histopathological analysis. As periodic CT scans showed progressive improvement of blood flow through the SMA, OAC was continued. OAC may have been beneficial due to the nature of emboli originating from a cardiac myxoma: thrombi covering the surface of the tumor. At present, there is no explanation in the literature for the benefits of OAC in patients with embolism associated with cardiac myxoma.

Keywords: Artéria mesentérica superior; Embolia; Embolism; Ischemia; Isquemia; Mesenteric artery; Mixoma; Myxoma.