Myxoma

Overview

What is a myxoma?

A cardiac myxoma is a tumor that affects your heart. It’s the most common noncancerous primary cardiac tumor. Myxomas vary in size. Some are as small as 1 centimeter in diameter. Others can be as large as 15 centimeters.

About 74% of all myxomas form in your left atrium, which is the top left chamber of your heart. About 18% form in your right atrium. Most myxomas are known as atrial myxomas because they form in your upper heart chambers. The rest (8%) form in your ventricles (lower chambers).

Myxomas usually grow from your atrial septum. This is the muscular wall that separates your left atrium and right atrium. And they’re usually connected to the septum by a pedicle, which is a stalk that allows the myxoma to be mobile. The tumor can move and sway, sometimes dropping into one of your heart valves and causing problems with blood flow.

Myxomas aren’t cancerous, but they’re still dangerous because they can interfere with your heart function. That’s why people who have myxomas need surgery to remove the tumors and prevent serious complications.

Who is affected by myxomas?

Myxomas usually affect people aged 30 to 60.

Myxomas are more common among women and people designated female at birth (DFAB) compared with men and people designated male at birth (DMAB).

These trends are different for people who have Carney’s complex. This genetic syndrome causes multiple myxomas in your heart and other parts of your body. People with Carney’s complex are usually diagnosed with myxomas in their early 20s. And they’re more likely to be men and those DMAB.

How common are myxomas?

Primary heart tumors (tumors that begin in your heart) affect fewer than 1 in 2,000 people. About half of all primary heart tumors are myxomas.

How does a myxoma affect my body?

Myxomas can interfere with blood flow throughout your body and within your heart. Complications include:

  • Embolism. An embolism is a blocked blood vessel that occurs when a blood clot or other particle gets stuck. Some myxomas have a friable (crumbly) texture. A piece can break off, travel through your blood and get stuck somewhere in your body. Blood clots can also form on the myxoma and eventually break off. Embolisms are the most common complication of cardiac myxomas. The effects vary based on which blood vessel gets blocked. A blockage affecting blood flow to your brain can cause a stroke.
  • Valve obstruction. Myxomas often grow on a stalk and swing back and forth within your heart chamber as blood flows through. If a myxoma swings into a valve opening, it can temporarily block blood flow through that valve. This often happens in your mitral valve, which connects your left atrium and left ventricle. This plug-and-unplug process can disrupt the smooth transport of blood through your heart and into your body.

Symptoms and Causes

What are the symptoms of a myxoma?

The symptoms of a myxoma vary based on where it’s located within your heart and how it’s affecting your body. You may experience:

  • Fever.
  • Lethargy (lack of energy).
  • Night sweats.
  • Raynaud’s phenomenon.
  • Shortness of breath with physical activity.
  • Shortness of breath or fainting when you stand. (This is because gravity pulls the tumor into your mitral valve, causing your blood pressure to temporarily drop.)
  • Weight loss.

What causes a myxoma?

Most myxomas don’t have a clear cause. But Carney’s complex causes about 10% of cases. If your biological family has a history of this syndrome, it’s important to tell your healthcare provider.

Diagnosis and Tests

How are myxomas diagnosed?

Healthcare providers diagnose myxomas through a physical exam and tests. Myxomas sometimes take a while to diagnose because their symptoms resemble the symptoms of other conditions.

During your physical exam, your healthcare provider will listen to your heart with a stethoscope. A myxoma may cause a heart murmur that has a characteristic “tumor plop” sound. This is the sound of the myxoma temporarily blocking your mitral valve.

Your healthcare provider will also talk with you about your symptoms and any changes in how you’ve been feeling. If they suspect you have a myxoma or another heart problem, they’ll run imaging tests.

What tests diagnose a myxoma?

Imaging tests are essential for diagnosing myxomas. Your healthcare provider may run one or more of the following tests:

  • Echocardiogram. A transthoracic echo can usually show a myxoma. But you may also need a transesophageal echo to check for small tumors or to see where a tumor attaches to your heart.
  • Cardiac MRI.
  • Cardiac CT scans.

A blood test may also reveal signs of a myxoma, including:

  • Low red blood cell count (anemia).
  • Low platelet count (thrombocytopenia).
  • High white blood cell count, which indicates inflammation.

These blood test findings don’t necessarily mean you have a myxoma. They could be due to other causes. But combined with imaging tests and exam findings, they can help your healthcare provider reach a diagnosis.

Management and Treatment

What is the treatment for a myxoma?

If you’ve been diagnosed with a myxoma, you’ll need surgery to remove the tumor. Your healthcare provider will tell you more about what to expect and how to prepare.

It’s important to remove a myxoma right away. Myxomas put you at a high risk of embolisms with life-threatening complications.

Outlook / Prognosis

What is the outlook for people with myxomas?

People with myxomas generally have a good outlook. Surgery can usually remove myxomas and prevent them from coming back.

But about 1% to 2% of people develop new myxomas within 10 to 15 years of their surgery. Recurrence is more common among people who have Carney’s complex.

This is why your healthcare provider will recommend routine imaging tests if you have a history of myxomas. These tests can detect the formation of new myxomas and lower your risk of future complications.

People who’ve had myxomas face a greater risk of atrial arrhythmias (rhythm problems in the upper chambers of your heart). Your healthcare provider will discuss your risk and prescribe medication if needed.

Living With

When should I see my healthcare provider?

Call your healthcare provider right away if you have any symptoms of a myxoma. These symptoms may indicate another heart problem, rather than a myxoma. But for any heart problem, it’s important to get checked and receive treatment early before things progress too far.

If you’ve been diagnosed with a myxoma, your healthcare provider will let you know how often you need to return for follow-ups and when you need surgery.

If you’ve had surgery to remove a myxoma, carefully follow your healthcare provider’s instructions for recovery and follow-ups.

What questions should I ask my provider?

Talk with your provider about your diagnosis and plan going forward. You may want to ask:

  • How large is the myxoma?
  • How is the myxoma affecting my heart?
  • Do I have more than one tumor?
  • When will I need surgery?
  • Do I need any medications to manage symptoms or complications?
  • How often do I need to come back for follow-ups or additional tests?

A note from Cleveland Clinic

Learning you have a heart tumor can feel scary and unsettling. But the good news is that myxomas can usually be removed through surgery, and about 98% of people never get them again. If you have Carney’s complex, you face a higher risk of recurrence. But visiting your healthcare provider for routine echocardiograms can help catch any signs of a new tumor before it leads to complications. If you need surgery, talk with your healthcare provider about what to expect and what your recovery will be like. It’s also important to talk with your provider about your risk for arrhythmias or other problems with your heart’s electrical system. You may need medication to manage such issues even after the tumor’s been removed.

Last reviewed by a Cleveland Clinic medical professional on 05/31/2022.

References

  • British Heart Foundation. All about Cardiac Tumors. (https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/all-about-cardiac-tumours) Accessed 6/1/2022.
  • European Society of Cardiology. Cardiac Tumors. (https://www.escardio.org/Education/Practice-Tools/EACVI-toolboxes/3D-Echo/cardiac-tumors) Accessed 6/1/2022.
  • Marwick TH, DeMaria AN, Blanchard DG, Zoghbi WA. Echocardiography. In: Fuster V, Harrington RA, Narula J, Eapen ZJ. eds. Hurst’s The Heart, 14e. McGraw Hill; 2017. Accessed 6/1/2022.
  • Merck Manual Professional Version. Cardiac Tumors. (https://www.merckmanuals.com/professional/cardiovascular-disorders/cardiac-tumors/cardiac-tumors) Accessed 6/1/2022.
  • Merck Manual Consumer Version. Myxomas. (https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/heart-tumors/myxomas?query=Cardiac%20Tumors) Accessed 6/1/2022.
  • Merck Manual Consumer Version. Overview of Heart Tumors. (https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/heart-tumors/overview-of-heart-tumors?query=Cardiac%20Tumors) Accessed 6/1/2022.
  • Reejhsinghani RS, Redberg RF. Cardiac Tumors. In: Crawford MH. eds. Current Diagnosis & Treatment: Cardiology 5e. McGraw Hill; 2017. Accessed 6/1/2022.
  • StatPearls. Atrial Myxoma. (https://www.statpearls.com/articlelibrary/viewarticle/17964) Accessed 6/1/2022.

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