Wednesday, 15 September 2010

MRCP revision battle 12.1: Atrial myxoma

Today's battles are a mixed bag; usually they are generated from past questions I've done while today's bunch include some motivated by gaps in clinical knowledge revealed during a recent take.  So the battles are:

MRCP revision battle 12.1: Atrial Myxoma
MRCP revision battle 12.2: CLL
MRCP revision battle 12.3: Hairy cell leukaemia
MRCP revision battle 12.4: Aortic dissection

MRCP revision battle 12.1: Atrial Myxoma

Atrial myxoma are usually benign tumours found in the atria.
75% are in the left atrium.

0.3% of the population are found to have an atrial myxoma at post mortem.
Females >males, 2:1

Atrial myxoma are usually sporadic but an autosomal dominant inheritance also exists.

They are usually benign but as they grow rapidly and embolise they require surgery.

Features of atrial myxoma include:
  • clubbing
  • weight loss
  • fever
  • AF
  • emboli
  • mid diastolic murmur - an 'atrial plop'

Investigations may show:
  • raised wcc
  • low platelets
  • raised ESR in 60%

After that brisk whizz through atrial myxoma, onward to CLL!