A 63-year-old man was admitted in hospital because of extreme weight loss (about 20 kg within 6 months), weakness, fatigue, exertional dyspnea, periods of hacking cough, and laboratory disturbances (elevated erythrocyte sedimentation rate, increased C-reactive protein values, disturbances in the protein electrophoresis), with no proper etiology. Before admission he was extensively examined due to the commonest reasons for the mentioned symptoms – occult malignancy, hematological, autoimmune, and infectious diseases. Since extensive diagnostic evaluation performed before hospitalization showed no discrepancies, we suspected a cardiac myxoma. Echocardiography revealed a large tumor in the right atrium.
The histology of surgically removed tumor revealed a cardiac myxoma. Five months later, his body mass increased by 15 kg. The patient remains well, with normal echocardiographic and laboratory findings. Our case suggests that echocardiography should be considered early in the examination of patients with markedly constitutional symptoms and laboratory disturbances in order to detect rare but treatable heart tumors.63-godišnji muškarac hospitaliziran je zbog izrazitog gubitka tjelesne mase (oko 20 kg tijekom 6 mjeseci), slabosti, umora, nedostatka zraka tijekom tjelesnih aktivnosti, povremenog kašljucanja i laboratorijskih poremećaja (ubrzana sedimentacija eritrocita, povećane vrijednosti C-reaktivnog proteina, otkloni u vrijednostima elektrofereze proteina) nepoznatoga uzroka. Pred prijam opsežno je obrađen zbog najčešćih uzroka navedenih simptoma – malignih, hematoloških, autoimmunih i zaraznih bolesti. Budući da dijagnostička obrada provedena prije hospitalizacije nije pokazala odstupanja, posumnjali smo na miksom srca. Ehokardiografskim pregledom zabilježen je veliki tumor u desnom atriju. Histološkom analizom kirurški odstranjenog tumora potvrđen je miksom. Pet mjeseci nakon operacije bolesnik se osjećao dobro, tjelesna masa mu se povećala za 15 kg, a ehokardiografski i laboratorijski parametri bili su u normalnim rasponima. Naš slučaj pokazuje da ehokardiografiju treba primijeniti u ranoj fazi obrade bolesnika s
izraženim konstitucionalnim simptomima i laboratorijskim poremećajima, u cilju otkrivanja rijetkih, ali izlječivih tumora srca