An 86-year-old woman developed embolic injury across five vascular beds over a two-week hospital stay, Cureus reported.
The patient initially presented to the emergency department after a fall from standing height triggered by a syncopal episode. Physicians later identified a left atrial mass that was initially interpreted as a thrombus on contrast-enhanced computed tomography. Transthoracic echocardiography subsequently characterized the mass as a 50 by 32 millimeter mobile lesion suggestive of myxoma. Histopathologic examination confirmed cardiac myxoma after surgical resection.
Primary cardiac tumors are rare, showing a reported prevalence of 0.001% to 0.03% in autopsy series. Embolic events affect 20% to 45% of patients with cardiac myxomas and frequently precede the diagnosis of the tumor itself.
The patient experienced embolic occlusion in the brain, both kidneys, the spleen, the ileocolic mesenteric territory, and both lower limbs. Brain magnetic resonance imaging demonstrated multiple acute lesions with restricted diffusion in cortical and subcortical locations of both frontoparietal regions, the right occipital, and periatrial regions.
Abdominal imaging revealed wedge-shaped hypodense areas in the renal parenchyma and bilateral splenic infarcts. Shortly afterward, the patient lost bilateral pulses from the popliteal level distally. Computed tomography angiography of the lower limbs showed acute embolic occlusion of the P2-P3 popliteal segments and tibioperoneal trunks bilaterally.
Exploratory laparotomy revealed transmural necrosis of the cecum and ileocecal valve with thrombosed ileocolic vessels. Surgeons performed a partial right colectomy with a distal ileostomy alongside bilateral lower limb embolectomy.
The patient underwent median sternotomy the following day for resection of the left atrial mass using cardiopulmonary bypass. Complete excision of the tumor was achieved, with curettage of the implantation site and irrigation of the cardiac chambers. The patient later died of septic shock secondary to anastomotic dehiscence and fecal peritonitis.
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