Myxoma of the heart is one of the most common neoplasms. In some cases, this disorder occurs due to hereditary predisposition. A tumor of the heart, myxoma, is most common in women over the age of 40 and young men.
Pathogenesis of disease
The most common benign heart tumor in adults is myxoma, in children it is rhabdimioma.
This disease has variable clinical manifestations as it can be caused by:
- Human papillomavirus.
- Einstein-Barr.
- Herpes.
Heart tumors are extremely rare. They are of two types:
- Primary tumors originate in the cells of the connective and supporting tissue, in the walls, ventricles of the heart. Most of them are benign.
- Secondary are formed if there are tumors near the heart. Also, harmful cells can enter from distant organs through the blood.
In 90% of all cases, myxoma is localized in the left atrium. In somecases, this disease occurs in combination with others, such as diseases of the adrenal glands or benign skin tumors.
Myxoma of the heart can be inherited, so people at risk of it need an annual examination.
Clinical picture of the disease
Signs are very diverse and depend on the location and size of the tumor. Neoplasm can lead to malfunctions of the heart. If the tumor is located in the walls, then heart failure may occur.
Classic signs of illness:
- continuous breathing problems;
- dizziness;
- palpitations;
- shortness of breath during any physical activity;
- chest pain;
- paroxysmal nocturnal dyspnoea;
- sudden death.
There may be general weakness. The tumor can affect the function of the heart valves, or a small part of it can come off and travel through the bloodstream to the lungs, brain and clog a blood vessel. In this case, the patient is expected to have a stroke - this is the first sign that a person has a myxoma of the heart. Symptoms vary and may include the following additional symptoms:
- general discomfort;
- fever;
- swelling of any part of the body;
- cough;
- joint pain;
- sensitivefingers, changing their color;
- cyanosis of the skin.
Also, when there is an abnormal heart rhythm, fainting and convulsions may occur. But they appear very rarely.
Among the victims who were diagnosed with a secondary form of the disease, there was weight loss, excessive sweating.
Basic methods for disease detection
The best and easiest diagnostic method is an ultrasound examination of the heart, called echocardiography in the professional language. It can show tumor size, position and mobility.
There are two ways to do this research:
- Using an ultrasound probe through the chest. The method is well suited to find out where the myxoma of the heart is located. The diagnosis also determines the size of the tumor.
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The second option is the so-called transesophageal echocardiography. During the procedure, a small ultrasound probe is inserted through the mouth into the esophagus. This examination is performed under light anesthesia to eliminate the gag reflex. This procedure is also suitable for the diagnosis of malignant tumors such as sarcoma.
The use of computed tomography and magnetic resonance imaging to examine the heart is now increasingly being used.
To confirm the diagnosis of atrial myxoma, doctors recommend several tests:
- troponin level;
- chest x-ray;
- ECG;
- cardiac catheterization;
- blood electrolyte levels;
- pulse oximetry.
Differential Diagnosis
Myxoma of the heart requires a thorough medical examination. Including such a procedure as a study of pulmonary ventilation and perfusion using scanning is necessary. It is carried out in order to exclude pulmonary embolism as the main cause of the disease.
Differential diagnosis is needed to distinguish symptoms from other medical conditions such as:
- primary pulmonary hypertension;
- tricuspid valve insufficiency;
- mitral regurgitation;
- mitral stenosis;
- tricuspid stenosis.
Open Heart Surgery
The best and most reasonable treatment is to completely remove the myxoma of the heart through surgery. If the doctor suggests you have surgery, you should not hesitate too long. To avoid complications, treatment must be carried out in a timely manner.
This type of surgery is the most common method. Open Heart Surgery Includes:
- Bypass.
- Valvuloplasty.
- Valve replacement.
- Transplantation.
- Surgical correctioncongenital heart defects.
In the United States, surgeons perform about 750,000 open-heart surgeries every year. This procedure requires general anesthesia and a hospital stay of three to ten days, depending on the operation. In some cases, the patient is admitted to the hospital for more than one month.
Surgical procedures
For open heart surgery, the surgeon makes a long longitudinal incision along the top of the sternum through the skin and tissue underneath, and then cuts to enter the chest cavity. Special retractors keep it open. To get to the heart itself, the surgeon must open the pericardium, the protective sac surrounding the heart.
It is often left open after the operation is completed. This is necessary to reduce the time of the operation and reduce the risk of postoperative complications.
The following conditions must be met for a surgical intervention:
- use of cardiopulmonary bypass;
- all items must be sterilized.
After the operation is completed, the surgeon restores the process of blood circulation through the heart. Medical professionals lower a person's body temperature to slow down body functions. Then restore blood circulation and heart contractions. The surgeon places stitches where necessary (they will be visible for several years).
After the myxoma of the heart is removed,the operation was successful, the patient is sent to the ward for further observation.
What complications can the patient experience?
Surgery is not always without complications. Sometimes a second operation is needed. Cardiac myxoma surgery needs a good team of surgeons and other doctors to make everything go smoothly.
Complications during surgery:
- Bleeding due to anticoagulants.
- Air embolism during cardiopulmonary bypass, which can lead to a stroke.
- Difficulty in restoring heart rate.
- Mistake of the surgeon.
- Unexpected anatomical anomalies not previously detected.
General complications may occur even after surgery:
- Bleeding at the site of the operation or on the surface of surgical sutures.
- Infections.
- Blood clots that can cause pulmonary embolism, stroke.
- Arrhythmia.
- Hypertension and heart failure.
In order to respond quickly to any of the above complications, the patient is kept under the supervision of cardiac intensive care medical staff for 12-48 hours.
What happens if you do not resort to surgery?
Many patients refuse surgery. The main reason for refusal is the fear of death on the surgical table. But ifif it is not carried out, myxoma of the heart will lead to a number of complications:
- Peripheral embolism.
- Arrhythmia.
- Pulmonary edema.
The disease is a benign neoplasm localized inside the heart. Don't neglect the symptoms as this can lead to serious consequences.
Although the tumor is benign, this does not mean that it does not need to be treated. Growth of a mass inside the heart can restrict blood flow through the mitral valve and lead to various indicators of mitral stenosis.
If you or any member of your family is experiencing signs of illness, contact your he althcare provider immediately.
Prospects and lifestyle changes
Prognosis after open heart surgery depends largely on the cause of the invasion. Many people return to normal activities after two months, but a visit to the doctor is a must. The chance of complications decreases over time.
Many, on the contrary, need to make some lifestyle changes. As a rule, this applies to food and exercise. Cardiologists recommend following a diet and daily workouts, which are determined individually.
