Atrial myxoma presenting with aphasia alone: a case report

Atrial myxomas are the most common primary heart tumours. Symptoms are produced by mechanical interference with cardiac function or embolization. Neurological symptoms may occur approximately in one third of the patients. We report a patient who was admitted to the emergency department with only a complaint of complete aphasia and without other neurological signs and symptoms. Transthoracic echocardiography demonstrated a large mobile mass sized 4 x 4.5 cm prolapsing into the left ventricle through the mitral valve from the left atrium, suggesting the diagnosis of atrial myxoma. After surgery, aphasia resolved completely. Our objective is to inform clinicians that aphasia alone can be a symptom of atrial myxoma. (Hong Kong j.emerg.med. 2009;16:168-171)