Intended for healthcare professionals

Practice A Patient’s Journey

Left atrial myxoma

BMJ 2013; 347 doi: (Published 26 July 2013) Cite this as: BMJ 2013;347:f4430
  1. Susie Layton, patient1,
  2. David P Ripley, cardiology registrar and advanced imaging fellow2,
  3. Nick G Bellenger, consultant cardiologist2
  1. 1Seaton, Devon, UK
  2. 2Royal Devon and Exeter Hospital, Exeter EX2 5DW, UK
  1. Correspondence to: D P Ripley david.ripley{at}
  • Accepted 18 June 2013

Susie Layton was 60 when she noticed increasing breathlessness, fatigue, and chest pain. A left atrial myxoma was subsequently excised. She was discharged home after five days, which she believes was too early

I was a seemingly healthy 60 year old working as a part time frame conservator. About three months before my diagnosis, I noticed being short of breath, particularly when using the stairs and climbing hills with my dog. I also experienced dizziness; felt generally tired, which I put down to aging; had occasional night cramps; and saw “stars” when bending; and I once collapsed at a supermarket. In addition, I was referred to an ear, nose, and throat surgeon in January 2011 for vocal cord weakness, as I was constantly clearing my throat especially when speaking on the telephone. A magnetic resonance imaging scan of my brain revealed nothing abnormal.

The week before my diagnosis I noticed increasing tiredness together with a dull ache on the left side of my chest. The day before I consulted my doctor I was walking on the flat with a friend. She persuaded me to seek help because she was concerned that my breathlessness was not caused by my asthma but possibly by my heart.

Diagnosis, waiting time, and results

My doctor arranged for a series of blood tests and electrocardiography to be carried out the same day at the surgery. He subsequently told me that he had called an ambulance as there were gross irregularities on the electrocardiogram and that he suspected ischaemic heart disease. I remember thinking he must be over-reacting because my chest pains were not that intense and I was shocked by his decision to call an ambulance. I was taken to the Royal Devon and Exeter Hospital, where I had further blood tests, was interviewed by a doctor, and had chest …

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