Left atrial myxoma supplied by the circumflex coronary artery arising from the right sinus of Valsalva.

Myxoma is the most common primary tumor of the heart. Although cardiac myxomas are histologically benign, they may be a source of emboli and cause intracardiac obstruction resulting in acute myocardial infarction. A 38-year-old male patient was admitted with a clinical presentation of acute coronary syndrome and angina of six-month history. The electrocardiogram showed sinus rhythm and pathological Q waves in leads D2-3 and aVF. Two-dimensional echocardiography showed a large immobile mass, 6.8x3.4 cm in size, in the left atrium, causing obstruction of the left ventricular inflow. The mass protruded through the mitral valve into the left ventricle. There was also inferior wall akinesia. Selective coronary angiography showed normal coronary arteries, but demonstrated marked neovascularization of the left atrial mass which was supplied by the left circumflex artery originating from the right coronary cusp. Ventriculography showed inferior wall akinesia. The patient was immediately submitted to cardiac surgery. The mass was resected and histologic diagnosis was atrial myxoma. The patient had an uneventful postoperative course.