The online version of this article (doi:10.1186/1471-2261-14-175) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
SYM drafted the manuscript and HTL treated the patient during hospitalization. Y-HL conducted the diagnosis and critically reviewed the manuscript. K-SK gave advice on the discussion of the manuscript. Transthoracic echocardiography was performed by JS. HK performed the surgical excision and embolectomy. All authors read and approved the final manuscript.
Multiple organ infarctions combined with Leriche syndrome due to embolic particles of myxoma are very rare. There is no definite guideline for immediate medical treatment.
A 36-year-old married female was referred to the emergency department (ED) with severe pain of both lower extremities and gradual decreased mental status. Brain magnetic resonance imaging (MRI) and computed tomography angiography (CTA) revealed acute multiple organ infarctions including the brain, spleen, and bilateral kidneys combined with Leriche syndrome. To evaluate the embolic source, echocardiography was performed and it revealed biatrial myxoma. Because of the risk of progression in systemic embolic events, surgical excision and embolectomy were performed urgently. After the operation, renal function was recovered, and the pain of both limbs was relieved. However, the visual field defect due to the brain infarction remained. She was discharged uneventfully on the fourteenth postoperative day.
This was an extremely rare case of multiple organ infarctions combined with Leriche syndrome as the initial presentation of biatrial myxoma. The treatment of choice for myxoma is surgical excision, but the optimal timing of operations is still controversial in patients who have had recent neurological insults. Echocardiography was useful to clarify the diagnosis and decide on the proper treatment modality: surgical treatment or thrombolysis.
Campbell JK: Early diagnosis of an atrial myxoma with central retinal artery occlusion. Ann Ophthalmol. 1974, 6: 1207-1208. 1210–1201 PubMed
Askar OS, Noureldin AH, Nair SC: Acute presentation of Leriche syndrome in United Arab Emirates: a case report. Case Reports International. 2014, 3: 6-9.
- Biatrial myxoma and multiple organ infarctions combined with Leriche syndrome in a female patient
Seung Yeon Min
Hyung Tak Lee
- BioMed Central
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