An Unusual Cause of Tricuspid Regurgitation and Right Heart Failure

Abstract

A 64-year-old female presented with complaints of multiple episodes of palpitations, pedal edema, and abnormal neck pulsations for the past 6 months. Pulse was regular and jugular venous pulse elevated with a prominent V wave and sharp Y descent. Cardiovascular examination revealed grade II left parasternal heave, epigastric pulsations, right ventricle S3, and a grade III high-pitched blowing pansystolic murmur at the left lower sternal border. Electrocardiogram, chest X-ray, and 24-h Holter monitoring were normal. We clinically diagnosed isolated right heart failure with nonhypertensive tricuspid regurgitation. Transthoracic echocardiography showed a huge right atrial tumor prolapsing into the right ventricle and right ventricular outflow tract along with significant tricuspid regurgitation. The tumor was removed surgically. Histopathological examination confirmed the diagnosis of right atrial myxoma. Right atrial myxoma presenting as pure tricuspid regurgitation and right heart failure is rarely reported in the literature.

Keywords

• right atrial myxoma
• right heart failure
• tricuspid regurgitation