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September 30, 1974

Left Atrial Myxoma: Clinical Presentation Suggesting Acute Myocarditis

Author Affiliations

From the departments of pediatrics (Drs. Neches, Park, Lenox, and Zuberbuhler) and surgery (Dr. Siewers), University of Pittsburgh School of Medicine, and the Section of Pediatric Cardiology (Drs. Neches, Park, Lenox, and Zuberbuhler), Children's Hospital of Pittsburgh.

JAMA. 1974;229(14):1906-1907. doi:10.1001/jama.1974.03230520048032

THE early diagnosis of left atrial myxomas is important since these tumors can be removed surgically, with excellent results.1-3 However, the signs and symptoms of a left atrial myxoma are variable and in most cases, the correct diagnosis is not suspected until after systemic embolization of tumor fragments has occurred.1,3,4 In many patients, the presence of mitral regurgitation has led to an erroneous diagnosis of rheumatic or viral myocarditis. This report describes the clinical findings that led to the correct diagnosis of left atrial myxoma in a child who was initially thought to have acute myocarditis.

Report of a Case  A 10-year-old boy was in excellent health until one week before admission when he developed signs and symptoms of an upper respiratory tract infection. Exertional dyspnea and orthopnea appeared and became increasingly severe. His physician first heard an apical systolic murmur two days before admission. There was no