Question
Atrial myxoma is associated with the following except:
| A. |
Fever |
| B. |
Weight loss |
| C. |
Systolic murmur at apex |
| D. |
Subungual splinter haemorrhage |
Show Answer
|
Correct Answer » D Explanation |
 |
Atrial myxoma is the most common primary cardiac tumor in adults.
Approximately 75% occur in the left atrium, usually attached to the interatrial septum near the fossa ovalis.
The clinical manifestations can be remembered by the triad:
- Intracardiac obstruction
- Embolization
- Constitutional symptoms
Why Option C is Correct (Exception)
Systolic Murmur at the Apex
- Not a typical finding of atrial myxoma.
- Left atrial myxoma usually intermittently obstructs the mitral valve.
- Therefore, it produces:
- Mid-diastolic murmur at the apex (mimicking mitral stenosis)
- Tumor plop (early diastolic sound)
Hence, a systolic murmur at the apex is not characteristically associated with atrial myxoma.
Why Other Options are Associated with Atrial Myxoma
A. Fever
- Common constitutional symptom.
- Due to cytokine production, especially Interleukin-6 (IL-6).
B. Weight Loss
- Also caused by cytokine release.
- May mimic infective endocarditis or connective tissue disorders.
D. Subungual Splinter Hemorrhage
- Occurs due to systemic embolization from the friable tumor.
- Tumor fragments or associated thrombi can embolize to peripheral vessels.