Putra IMANULLAH, Abinisa Inaya TAIM, Filianmi Dyospama PATANDIANAN, Pendrik TANDEAN, Jayarasti KUSUMANEGARA
Journal of Updates in Cardiovascular Medicine - 2026;14(2):52-55
The differential diagnosis of a mitral valve mass includes infectious vegetation, papillary fibroelastoma, and, rarely, cardiac myxoma. Distinguishing these masses from other valvular lesions is crucial, as the management strategies can differ significantly. We present a case of a 69-year-old man admitted to the cardiac emergency unit with chest pain. Further investigations revealed ST-elevation myocardial infarction affecting both the anteroseptal and inferior walls, along with pulmonary edema. Transthoracic echocardiography revealed severe mitral regurgitation associated with an oscillating mass originating from the anterior mitral leaflet, measuring 13 mm x 10 mm. Despite negative blood cultures, the mitral valve mass was initially managed as infective endocarditis. However, the patient failed to demonstrate any significant clinical improvement. Subsequent coronary angiography identified two-vessel coronary artery disease with a SYNTAX II score of 22. Given these findings, the decision was made to proceed with coronary artery bypass grafting in conjunction with resection of the mitral valve mass and mitral valve replacement. Histopathological analysis of the excised tissue ultimately revealed the characteristics of a cardiac myxoma.
