Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Images in Cardiovascular Medicine
Tumor Plop Sound
Ryota KakizakiTakeru NabetaTomohiro MizutaniToshimi KoitabashiJunya Ako
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Supplementary material

2016 Volume 80 Issue 11 Pages 2407-2408

Details

A 64-year-old woman was referred to hospital with heart murmur. She had a history of sudden pain and purpura in the left index finger. An elevated first heart sound, a systolic murmur and an early diastolic plop sound after the second heart sound were audible at the apex. On phonocardiogram, a tumor plop sound was recognized as a high-pitched sound after the second heart sound (Figure 1). Echocardiography showed a large mass measuring 82×30 mm located in the left atrium, prolapsing into the left ventricle (Figure 2A). The patient underwent resection of the cardiac tumor. Gross examination of the specimen showed a polypoid, pedunculated, round tumor with a lobulated surface (Figure 2B). On histology characteristic acid-mucopolysaccharide matrix-embedded polygonal cells were seen, which confirmed the diagnosis of cardiac myxoma.

Figure 1.

Phonocardiogram at the time of admission, showing tumor plop sound recognized as a high-pitched sound after second heart sound (arrow).

Figure 2.

(A) Echocardiography showing a large mass located in the left atrium. (B) The tumor was polypoid, pedunculated, and round with a lobulated surface.

Cardiac myxoma is the most common benign heart tumor.1,2 The tumor plop sound is one of the classic and characteristic auscultation findings of cardiac myxoma.3,4 Although tumor plop sound is rare, it provides an important opportunity for the diagnosis of cardiac tumor.

Disclosures

The authors declare no conflicts of interest.

Supplementary Files

Supplementary File 1

Movie S1. Echocardiography on admission, showing a large cardiac myxoma located in the left atrium, prolapsing into the left ventricle.

Please find supplementary file(s);

http://dx.doi.org/10.1253/circj.CJ-16-0804

References
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  • 2.    Reynen  K. Cardiac myxomas. N Engl J Med 1995; 333: 1610–1617.
  • 3.    Pitt  A,  Pitt  B,  Schaefer  J,  Criley  JM. Myxoma of the left atrium: Hemodynamic and phonocardiographic consequences of sudden tumor movement. Circulation 1967; 36: 408–416.
  • 4.    Bass  NM,  Sharratt  GP. Left atrial myxoma diagnosed by echocardiography with observation on tumor movement. Br Heart J 1973; 35: 1332–1335.
 
© 2016 THE JAPANESE CIRCULATION SOCIETY
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