Cardiac tumors are unusual, but atrial myxomas are the most common benign cardiac tumors of the heart. Presentations can be highly variable, ranging from signs and symptoms of mitral valve disease (such as dyspnea) to embolic phenomenon, right heart failure, or rarely myocardial infarction or sudden death. In this interesting case, a patient presented with findings of left and right heart failure and was treated in the operating room with a minimally invasive approach (right mini-thoracotomy including left atrial myxoma excision and mitral and tricuspid valve repair.)

• To describe the potential physiologic consequences of large left atrial myxoma
• To recognize the typical appearance of left atrial myxoma on echocardiography
• To identify clinical factors suggesting multiple cardiac myxomas and the associated familial syndrome (Carney Complex)