Dawaa Reference

Clinical reference

Benign cardiovascular neoplasm

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Atrial Myxoma - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK535384/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class KD25.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (8)

  • Left-sided tumour mimics mitral obstruction, left heart failure and lung congestion
  • Breathlessness on exertion is commonest, then orthopnoea, night-time attacks and pulmonary oedema [breathlessness · oedema · orthopnoea]
  • Right-sided tumour behaves like tricuspid stenosis and right heart failure [stricture]
  • Right-sided: breathlessness on effort and swollen feet [breathlessness · leg swelling]
  • Embolism can present as a transient ischaemic attack, hemiplegia, sudden vision loss, chest pain or breathlessness [breathlessness · chest pain · ischaemia · one-sided weakness]
  • Fever, malaise, poor appetite, joint pain and weight loss [fever · joint pain · malaise · poor appetite · weight loss]
  • In Carney complex: odd skin pigmentation and tumours of adrenal, thyroid, testis or ovary
  • Carney complex with a pituitary adenoma can bring acromegaly, and myxomas recur after removal

Signs — what you find (7)

  • An early diastolic tumour plop on auscultation with a left-sided tumour
  • Right-sided: a diastolic murmur over the tricuspid area and sometimes a prominent jugular a wave [heart murmur]
  • Enlarged liver and ascites with a right-sided tumour [ascites · hepatomegaly]
  • Tumour invading the heart muscle produces arrhythmias, either side [arrhythmia]
  • Left-sided tumours embolise widely: brain, retinal arteries, spleen, kidneys, adrenals and limb arteries
  • Neurological damage is the gravest embolic complication of a left-sided tumour
  • Lung embolism from the right side shows as low oxygen, fast pulse, or sudden death [sudden cardiac arrest]

Tests (9)

  • Bloods may show anaemia, high white count, low platelets, raised ESR and raised gamma globulin
  • Echocardiography is usually the first-choice test
  • Echo shows size, site, attachment and mobility of the mass, plus how far it blocks flow or sheds emboli
  • Transoesophageal echo beats transthoracic for atrial masses and picks up tumours as small as 2 mm
  • Cardiac MRI adds anatomy plus tissue character on T1 and T2 sequences
  • Cardiac CT substitutes where MRI is unavailable or unsafe
  • PET can characterise these tumours but is used rarely
  • Coronary angiography maps the tumour blood supply and is routine before surgery
  • Imaging alone is usually enough; transvenous biopsy risks dislodging emboli

If not this — what else fits (3)

  • Mural thrombus with myxoid stroma is the main mimic, and looks the same down the microscope
  • Calretinin staining is what separates a myxoma from a myxoid thrombus
  • Malignant mimics: primary cardiac sarcoma, primary cardiac lymphoma, large B-cell lymphoma

SourceStatPearls "Atrial Myxoma" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

Includes benign growths such as cardiac myxoma; referral to cardiology or cardiac surgery for imaging and likely excision is the GP's role since there is no medical treatment. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Includes benign growths such as cardiac myxoma; referral to cardiology or cardiac surgery for imaging and likely excision is the GP's role since there is no medical treatment.

Cautions
  • Myxoma can cause embolic stroke or sudden obstruction of blood flow (syncope, positional symptoms) — treat suspicious cases as urgent.
  • Rare in Egyptian primary care.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.