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Background <p>Cardiac myxomas are the most common primary cardiac tumors and, despite benign histology, can cause systemic embolization. Coronary embolism is uncommon and left main coronary artery (LMCA) occlusion is exceptionally rare. We report a case of non–ST-elevation myocardial infarction (NSTEMI) with presumed LMCA embolization highlighting the value of early echocardiography and a heart-team approach.</p> Case Presentation <p>A 49-year-old man with no significant past medical history presented with dyspnea and chest pain. He was initially treated at a regional hospital and transferred to our center for catheterization. At admission, transthoracic echocardiography revealed a mobile left-atrial mass consistent with myxoma. Twelve hours after arrival he deteriorated hemodynamically; urgent angiography demonstrated an abrupt LMCA occlusion. Aspiration/mechanical thrombectomy was attempted but unsuccessful, and bailout stenting restored TIMI 3 flow. One month later, definitive surgical excision of the mass was performed. The patient recovered well.</p> Conclusions <p>This case illustrates a rare presentation of cardiac myxoma with presumed embolic LMCA occlusion manifesting as NSTEMI. Early echocardiography can reveal non-atherosclerotic etiologies in atypical acute coronary syndrome, and coordinated care integrating immediate reperfusion with timely surgical resection is critical for optimal outcomes.</p>

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Left Atrial Myxoma Presenting as NSTEMI with Left Main Coronary Artery Occlusion: Case Report and Literature Review

  • 期刊论文

  • 发表日期：

    2026年2月18日

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  • Hung Minh Ngo,
  • Nghia Phu Nguyen,
  • Anh Tuan Nguyen,
  • Phieu Van Duong,
  • Thao Hoang Ngoc Duong,
  • My Tra Mai,
  • Ai Cao My Bui,
  • Hien Quang Nguyen,
  • Minh H. N. Le

摘要

Background

Cardiac myxomas are the most common primary cardiac tumors and, despite benign histology, can cause systemic embolization. Coronary embolism is uncommon and left main coronary artery (LMCA) occlusion is exceptionally rare. We report a case of non–ST-elevation myocardial infarction (NSTEMI) with presumed LMCA embolization highlighting the value of early echocardiography and a heart-team approach.

Case Presentation

A 49-year-old man with no significant past medical history presented with dyspnea and chest pain. He was initially treated at a regional hospital and transferred to our center for catheterization. At admission, transthoracic echocardiography revealed a mobile left-atrial mass consistent with myxoma. Twelve hours after arrival he deteriorated hemodynamically; urgent angiography demonstrated an abrupt LMCA occlusion. Aspiration/mechanical thrombectomy was attempted but unsuccessful, and bailout stenting restored TIMI 3 flow. One month later, definitive surgical excision of the mass was performed. The patient recovered well.

Conclusions

This case illustrates a rare presentation of cardiac myxoma with presumed embolic LMCA occlusion manifesting as NSTEMI. Early echocardiography can reveal non-atherosclerotic etiologies in atypical acute coronary syndrome, and coordinated care integrating immediate reperfusion with timely surgical resection is critical for optimal outcomes.