Clinical manifestations of coronary artery embolism due to heart tumors

R.M. Vitovsky ^{1, 2}, V.V. Isaіenko ^{1, 2}, O.V. Kupchinsky ¹, I.V. Martyschenko ¹, M.M. Serdyuk ¹

¹ M.M. Amosov National Institute of Cardiovascular Surgery of NAMS of Ukraine, Kyiv, Ukraine
² Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine

The aim – to present the features of the clinical manifestations and course of two cases of embolism of the coronary arteries, in which fragments of left atrial (LA) tumors served as the embolic substrate.

Materials and methods. This article discusses two cases of embolism with tumor fragments of the coronary arteries. In this case, the neoplasms were located in the left heart. Of particular interest is the fact that the clinical manifestations of embolism varied significantly, from severe pain requiring endovascular intervention, to minor discomfort lasting for several hours, without necessity of the inpatient treatment.

Results. It should be noted that in both cases, a tumor lesion of the heart was detected several months after primary manifestation of the disease, namely, embolism of the coronary arteries. Echocardiography study made possible to get a correct diagnosis. In one case it was a routine examination 6 months after stenting of the coronary artery. The reason to perform echocardiography in another case was the result of electrocardiography, showing necrotic changes of the left ventricular posterior wall. In both cases, echocardiographic data prompted immediate surgery of the neoplasms. The structure of neoplasm samples obtained as a result of the surgery confirmed the possibility of coronary artery embolism with tumor fragments.

Conclusions. Embolic complications may be a first manifestation of cardiac tumor. Fragmentation of the heart neoplasms may lead to damage of the cerebral and coronary arteries. Embolic complications can occur in young patients. Coronary artery embolism in cardiac tumors is associated with diverse clinical manifestations.

Key words: myxoma, heart tumors, embolic complications, coronary arteries, coronary angiography.

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