Tumor Plop Sound

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.