A giant left atrial myxoma as a cause of a low cardiac output syndrome - A case report

Klinika Chirurgii Serca, Akademia Medyczna, Wrocław, Poland.
Kardiologia polska (Impact Factor: 0.54). 04/2004; 60(3):260-2.
Source: PubMed


A case of a 75-year-old female with a giant left atrial myxoma (54 x 42 mm in transthoracic echocardiography) is presented. She remained in a stable condition, however, developed a low cardiac output syndrome shortly after echocardiographic examination. This was caused by tumour displacement from the atrial wall into the left ventricle. The patient underwent urgent surgery during which the tumour was successfully removed. Histopathological examination confirmed the diagnosis of myxoma. Six months after surgery the patient is doing well.

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    ABSTRACT: Summary Left atrial sporadic cardiac myxoma (CM) is the commonest benign tumor of heart. Till now no drug is available and surgery is the only treatment option which frequently evokes post-surgery complaints mainly recurrence and other cardiac problems. Therefore, there is a dare need of alternative treatment options. But due to the rarity of the disease, less characterization, and unknown biology; drug targets are not yet identified. In this study, using approaches from bioinformatics, molecular markers in CM have been identified and subsequent critical disease pathways have been developed. Then analyzing pathway networks, potential drug targets are identified. Finally, various miR analysis databases and tools are used to identify potential miRs those may block the entire critical disease pathway. Analysis shows that seven groups of molecular markers and five critical disease pathways (either solitary or in interplay) are involved in CM development. 37 key nodes and several potential drug targets have been identified and combination of let-7, miR-125, miR-205, miR-214, miR-217, and miR-296 found to target maximum key molecules and predicted to have potentiality to disrupt the entire critical disease pathway network. The precise role of these miRs in CM development and their potentiality in CM therapy need to be thoroughly studied keeping in mind the challenges in RNA based therapeutics. Similarly these identified drug targets are required to be experimentally evaluated with novel targeting agents. In this article we have also provided an overview of cardiac myxoma. But because of the rarity of the disease, a systematic and multi-institutional approach is essential for better understanding of the molecular pathogenesis and subsequent drug development.
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    ABSTRACT: Treatment of sporadic cardiac myxoma (CM) has always been a challenging task. Currently, surgical excision remains the only option; however, targeted drug discovery schemes are in progress in order to improve treatment strategies and efficacy. The molecular mechanisms behind CM pathogenesis are still not totally unveiled thus drug target identification is still at early steps, trying to compile structured data on the pathophysiology of CM, targets and targeting moieties. Five critical disease pathways involving molecules of seven functional groups have been recently shown by us to be associated with the pathogenesis of CM. In addition, 15 to 20 drug targets and their targeting molecules have also mapped on pathways in an effort to start decoding the molecular profiles based on which early efforts for CM patient stratification into targeted therapeutic regimes. The present review describes the current data and discusses critical issues in the field of targeted and personalized medicine of CM.
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