A Mysterious Fall Was the First Sign Something Was Wrong

Myxomas are 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. The size may be variable at the time of diagnosis. Most are oval, and they can range from as small as a pea to the size of a large grapefruit. These tumors are often found by mistake, as in this case, the ultrasound was ordered to look for something else. But they can cause symptoms and, rarely, death.

To understand damage, it’s important to know the anatomy, Minella explained. The heart is divided into four chambers – the right side of the heart receives deoxygenated blood from the rest of the body. When the heart beats, the blood on the right side is squeezed into the lungs, where it is reloaded with oxygen. When the heart relaxes, that newly oxygenated blood flows to the left side of the heart. The two sides are divided into two parts: the atrium, a thin-walled chamber that receives blood, and the more muscular ventricle, which pushes blood to its next stop, either the lungs (from the right side) or the rest of the body. (from left). Small clots may form on the surface of these tumors. If the mass is on the left side of the heart — where most are — a loose clot can travel to the brain and cause a stroke. If the clot moves to the lung on the right side, where this patient’s mass is seen, blood flow is stopped.

Less common but more worrisome was the potential for blockage within the heart. When the heart is squeezed with each beat, the mass is pushed toward the valve that separates the atrium from the ventricle. If it somehow blocks that opening, no blood will be able to drain. That’s probably what happened to her at the beauty parlor, Minella explained. That episode was most likely due to this sudden loss of blood flow to the brain. And when he stumbled, he forced the mass out of the valve, and blood flow resumed. The myxoma looked like it was the right size to block that opening. She was lucky that it didn’t happen more often.

The tumor has to be removed as soon as possible, Minella told the patient and her husband. The risk was small but real. Surgery took place three days later. The surgeon had to cut his chest wide open from the neck to the bottom of his sternum. Only then could he safely remove the tumor.

Once when the woman was at home, her friend Sandi came to meet her. Sandy was worried because the woman previously told what the ultrasound showed. When Sandy came home from the funeral, she read about those tumors. So he called Minella’s office that afternoon. She wanted to make sure that the next funeral she went to was not her friend’s.