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Emergency presentation of emboli to multiple sites from an atrial myxoma


  • Gordon Michael Nicholls, MBChB, FACEM, Emergency Medicine Physician; Garry Clearwater, MBChB (Auck), FACEM, Emergency Medicine Specialist.

Dr Gordon Michael (Mike) Nicholls, Emergency Department, Auckland City Hospital, Private Bag 92 024, Auckland Mail Centre, Auckland 1142, New Zealand. Email:


A middle aged man presented to our ED with back pain and confusion, had evidence of acute arterial insufficiency to his lower limbs and myocardial infarction on initial ECG. His workup included an urgent CT, which revealed a filling defect in his dilated left atrium, renal and splenic infarcts, and an embolism in his left internal iliac artery. Urgent embolectomy and fasciotomy could not save his left lower limb, and emergency cardiac surgery was required to excise an atrial myxoma. A brief narrative review of the literature is also presented, with this case being unusual in causing such widespread concurrent multiple organ damage, including stroke and myocardial infarct.