A 51-year-old woman has had several syncopal episodes over the past year. Each episode is characterized by sudden but brief loss of consciousness. She has no chest pain. She has no ankle edema. On brain MRI there is a 1.5 cm cystic area in the left parietal cortex. A chest X-ray shows no cardiac enlargement, and her lung fields are normal. Her serum total cholesterol is 6.5 mmol/L. Which of the following cardiac lesions is she most likely to have?

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Quizplus · Accepted Answer

The patient's symptoms of sudden, brief loss of consciousness without chest pain or signs of heart failure, combined with a normal chest X-ray, suggest a non-ischemic cause for her syncopal episodes. A left atrial myxoma, a type of primary heart tumor, can intermittently obstruct blood flow from the left atrium to the left ventricle, leading to episodes of syncope. The absence of findings that would suggest the other listed conditions (such as signs of systemic disease for cardiac amyloidosis, chest pain or evidence of heart failure for ischemic cardiomyopathy, mitral valve abnormalities for mitral valve prolapse, or signs of infection for tuberculous pericarditis) further supports this diagnosis.

A 51-Year-Old Woman Has Had Several Syncopal Episodes Over the Past