Myxomas are very rare. In autopsy studies, about 100 myxomas are seen per million population. For reasons that are not well understood, they are more common in women than in men. Dimensions at the time of diagnosis may vary. Most are ovoid, and they can range in size from as small as a pea to the size of a large grapefruit. These tumors are often found incidentally, as in this case, during ultrasounds ordered to look for something else. But they can cause symptoms and are rarely fatal.
To understand its harmful effects, Minella explains, it’s important to know the anatomy. 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 forced into the lungs, where it is refilled with oxygen. When the heart relaxes, newly oxygenated blood flows to the left side of the heart. Both sides are divided into two parts: the atrium, a thin-walled chamber that receives blood, and the ventricle, which has more muscle, which helps push the blood to its next stop, which is the lung (from the right) or the rest of the body . (from the left side). These tumors may have small lumps on their surface. If the mass is on the left side of the heart – where most tumors are – a loose blood clot can travel to the brain and cause a stroke. If on the right side, where this patient’s tumor was seen, the clot would travel to the lung, cutting off blood flow there.
Less common but more worrisome is the possibility of a blockage in the heart. As the heart contracts with each beat, the mass is pushed toward the valve that separates the atria and ventricles. If it had somehow blocked that opening, no blood would have been able to get through. That’s probably what happened to her in the beauty salon, Minella explained. That condition is most likely caused by a sudden loss of blood flow to the brain. And when she tripped, she shoved the mass away from the valve, and the blood flow resumed. Myxoma looks as if it were just the right size to block that opening. She was lucky it didn’t happen more often.
Minella told the patient and her husband that the tumor would have to be removed as soon as possible. The risk is small but real. The surgery took place three days later. Doctors had to cut her chest wide from the neck down below the breastbone. Only then can he safely remove the tumor.
When the woman was at home, her friend Sandi came to see her. Sandi has been worried since the woman first described what the ultrasound showed. When Sandi got home from the funeral, she read about the tumors. That’s why she called Minella’s office that afternoon. She wanted to make sure the next funeral she went to wasn’t her friend’s.
