Myxoma

Description:

The heart myxoma — a benign intracavitary tumor, makes up to 50% of all primary new growths of heart. In 75% of cases the tumor affects the left auricle, in 20% — right. In other cases it is located in heart ventricles, sometimes there is an involvement of the valve device.

Myxomas make 50% of all benign tumors of heart at adults and 15% — at children. Myxomas at newborns — casuistry. Sporadic myxomas at women arise by 4 times more often than at men, hereditary forms — with an identical frequency at both floors. The largest frequency of myxomas is revealed at the age of 30–60 years. 94% of sporadic myxomas solitary, 22% of hereditary forms multilokulyarny. About 75% of myxomas arise in the left auricle, 15–20% — in the right auricle, 6–8% — in ventricles. 21–76% of hereditary forms recur after operational treatment, sporadic forms almost never recur. About 20% of patients with hereditary forms have the accompanying oncological diseases (an adrenocortical nodal dysplasia, tumors from Sertoli's cells, epiphysis tumors, multiple miksoidny fibroadenomas of a mammary gland, skin myxomas, a multiple nevus of the person and lips). According to pathoanatomical openings, the frequency of identification fluctuates from 0,0005 to 0,02%.

Myxoma symptoms:

Allocate the main clinical signs allowing to suspect or confirm existence of a myxoma of heart. Sudden emergence of the clinical signs of a circulatory unefficiency depending on a postural change of a body of the patient. Bystry development of cardiovascular insufficiency without the visible reasons and against the background of the corresponding therapy. The small duration of a disease in comparison with rheumatic heart diseases. Developing of embolisms of peripheral vessels or vessels of lungs against the background of a sinoatrial rate, especially at young people; at the same time the embolectomy with a histologic research of an embolus can facilitate diagnosis of a tumor. The asthma or a short-term loss of consciousness coming suddenly. Variability of noise at a postural change of a body of the patient. An infectious endocarditis, tolerant to antibacterial therapy.
Complaints of patients are caused by three pathological mechanisms — embolisms, obstruction of a blood-groove and constitutional signs (the reason of the last is unknown, most likely — multiple small embolisms or autoimmune reaction). Rather rare and late complication of myxomas — an infectious endocarditis.

Symptoms arise at 30–40% of patients. As the majority of myxomas is localized in the left departments, about 50% of embolisms occur in extra-or intracranial arteries of a brain, and also in vessels of the lower extremities, is more rare — in intestines vessels, coronary and renal arteries. Embolisms at right-hand myxomas usually also lead bessimptomna only to the moderate pulmonary hypertensia revealed instrumentalno.
Symptoms of obstruction of a blood-groove: Stenosis of the mitral valve; Aorta valve Stenosis; Stenosis of the three-leaved valve; Stenosis of the valve of a pulmonary artery.
Constitutional symptoms:  decrease in body weight weakness, subfebrile body temperature, nausea. Laboratory changes — a leukocytosis, increase SOE, hemolitic anemia, thrombocytopenia, the increased maintenance of SRB, IgG and SILT-6. Reynaud's syndrome, arthralgias, mialgiya, erythematic rash, lethargy (seldom).

Myxoma reasons:

In 80% of cases of a myxoma arise at people with a normal genome. In 5% of cases it is possible to establish the family nature of pathology, in this case 20% of patients have various genetic anomalies (more often than others — a tetraploidiya). Apparently, there is an interrelation between injuries of heart, previous DMZhP plastics, a transseptal puncture, transdermal balloon dilatation of the mitral valve and the subsequent development of a myxoma.

Treatment of the Myxoma:

Myxomas, as a rule, delete in the surgical way. The surgeon deletes a myxoma with capture not less than 5 millimeters of surrounding healthy fabrics of an interatrial partition. The plastics of a partition is carried out, using material of a cordial bag (pericardium).