# Intermittent Diplopia and Dyspnea: The Subtle Face of a Cardiac Myxoma

## TL;DR

A 53-year-old man with unusual symptoms like diplopia and dyspnea was found to have a cardiac myxoma, highlighting the importance of recognizing rare tumor presentations.

## Contribution

This case report highlights the subtle and atypical clinical presentation of a cardiac myxoma.

## Key findings

- A left atrial mass was identified as the cause of the patient's symptoms.
- Symptoms resolved after surgical excision of the mass.
- Initial diagnostic workup suggested non-specific or alternative pathologies.

## Abstract

Cardiac myxomas are rare primary cardiac tumors that present with clinical features that mimic a broad range of pathology; therefore, understanding the manifestations of the disease is essential for prompt diagnosis. In this case, a 53-year-old male presented after an episode of presyncope, with a six-month history of diplopia, diffuse finger and toe pain, exertional shortness of breath, cyclical fevers, and fatigue. It is a subtle, nonspecific presentation more suggestive of rheumatological or neurological disease than a primary cardiac pathology. MRI of the brain showed no acute pathology, but further workup revealed elevated inflammatory markers, pulmonary congestion, and rSr' pattern on EKG, suggesting possible right ventricular (RV) strain or conduction system disease. To evaluate for structural heart disease causing presyncope, an echocardiogram revealed a left atrial mass that was excised with resolution of symptoms.