Atrial myxoma

Q: What are a few of the broad differential diagnoses for this appearance? show answer

A: Cardiac enlargement (e.g cardiomyopathy), pericardial effusion, anterior mediastinal mass (e.g. thymic tumour - unlikely).

Q: What does splaying of the carina imply? show answer

A: Enlargement of the pericardial sac in the region of the left atrium - not expected if this represented an anterior mediastinal mass.

Q: How would you next image this patient? show answer

A: Transthoracic echocardiography is probably a good start; it would not only allow you to distinguish between pericardial and cardiac causes, but also allow for quantification of cardiac function.

Q: What is the likely diagnosis? show answer

A: Cardiac myxoma.

Q: When symptomatic, what are the three main forms of clinical presentation? show answer

A: Valvular obstruction, embolic events, constitutional symptoms.

Q: Where are they usually located? show answer

A: 95% in the atria, 75% left atrium

Q: For extra radiology-geek points: what is Carney complex? show answer

A: Multiple endocrine neoplasia syndrome, cardiac myxomas (often multiple) and skin pigmentation...