A Rare Cause of Platypnea: Left Atrial Myxoma

Abstract

Platypnea- Orthodeoxia syndrome approximately 150 cases have been reported. The patients are usually elderly and majority of them have a right-left intracardiac shunt. It is associated with Lung and liver diseases, drug intoxications, and pericardial diseases. According to our literature, there is only one case with platipne diagnosed as myxoma which has been resolved after mass excision. We presented an atrial myxoma case causing platipne which is rarely comes to mind as a differential diagnosis in patients with positional presyncope and dyspnea. 45 year-old woman, was admitted to the department of neurology because of presyncope ongoing 3-4 months, Neurological examinations was normally so she was referred to cardiology. After detailed physical examination,transthoracic echocardiography (TTE) was performed. TTE was showed a giant mobile left atrial mass(4.55x3.19 cm) prolapsing into the left ventricular cavity through the mitral valve and causing severe mitral stenosis. Mass has been excised by surgery and histological diagnosis was myxoma.