rarely visualized.The mainstay in the diagnosis of cardiac myxomas is 2-D Doppler echocardiography (130,138,144,156,158,161,173,174). In a retrospective review, myxomas were diagnosed in 37% of patients before, and in 90% ofpatients after, the advent of echocardiography (175). The virtual pathognomonic finding of an atrial myxoma isthat of a large pedunculated tumor mass traversing through the atrioventricular valve in a to-and-fro motion (Figs.72.1B and 72.9). In some patients, however, the tumor may not appear to prolapse into the ventricle either as aresult of a short pedicle or because of its large size (158,173). Single ventricular (158), biatrial (138), andsimultaneous atrial and ventricular myxomas (144) have been diagnosed accurately by this technique. Semilunarvalve obstruction (135,158) has been corroborated by Doppler technique. Similar to rhabdomyomas and fibromas,pericardial effusions have not been reported with atrial myxomas.
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