From the Guidelines
The false statement regarding atrial myxoma is A) In most cases it is autosomal dominant. Atrial myxoma is typically a sporadic condition, occurring randomly without genetic inheritance in the majority of cases. Only a small percentage of atrial myxomas are familial, occurring as part of specific syndromes. Atrial myxomas are associated with various conditions, including:
- Raynaud's phenomenon (option B), where patients experience episodic vasospasm of peripheral arteries
- Connective tissue diseases (option C), such as systemic lupus erythematosus and rheumatoid arthritis
- Embolic phenomena in the peripheries (option D), which are a common and serious complication of atrial myxomas, occurring when tumor fragments or thrombi formed on the tumor surface break off and travel through the circulation, potentially causing stroke, myocardial infarction, or peripheral arterial occlusion, as noted in guidelines for the primary prevention of stroke 1. These embolic events occur in approximately 30-40% of patients with atrial myxomas, highlighting the importance of surgical excision of atrial myxomas to prevent such complications.
From the Research
Atrial Myxoma Characteristics
- Atrial myxoma is the most common form of benign cardiac tumors, primarily occurring in the atria 2, 3, 4.
- These tumors are mostly idiopathic in origin, but rare cases have a family history of myxomas, suggesting that while there can be familial occurrences, they are not typically described as autosomal dominant in most cases 2.
- Atrial myxomas can cause serious complications, including embolic events and obstruction of intracardiac blood flow 2, 5.
- Embolic phenomena, including to the peripheries and the central nervous system, are recognized complications of atrial myxoma 6, 5.
Associations and Complications
- There is evidence that atrial myxomas can be associated with connective tissue disease, although this is not universally present in all cases 6.
- Raynaud's syndrome and connective tissue disease associations are less commonly discussed in the context of atrial myxoma but can be relevant in certain cases 6.
- The primary concern with atrial myxomas is their potential to cause embolic events, which can lead to serious complications, including stroke and peripheral embolism 2, 6, 5.
False Statement Identification
- Given the information provided, statement A "In most cases it is autosomal dominant" appears to be the false statement regarding atrial myxoma, as most myxomas are idiopathic and not typically described as having an autosomal dominant inheritance pattern in the majority of cases 2.