Cardiology: left atrial myxoma: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: left atrial myxoma

Sample item

A 45-year-old woman has fever, weight loss and a raised ESR. She also has episodes of breathlessness and presyncope on sitting up, and a low-pitched early diastolic sound that changes with posture. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Left atrial myxoma

A pedunculated tumour attached to the interatrial septum can intermittently obstruct the mitral orifice, causing postural symptoms and a tumour plop. Constitutional features and a high ESR come from interleukin-6 release by the tumour. Echocardiography is diagnostic and treatment is surgical excision.

Option by option

  • A. Subacute infective endocarditis

    Subacute endocarditis causes fever and a murmur but not postural obstruction or a posture-dependent sound.

  • B. Constrictive pericarditis

    Constrictive pericarditis causes a pericardial knock and features of right-sided congestion, with no postural variation.

  • C. Left atrial myxoma (correct)

    Correct. Positional obstruction, a tumour plop and constitutional features fit a left atrial myxoma.

  • D. Rheumatic mitral stenosis

    Rheumatic mitral stenosis gives a fixed opening snap and loud first sound without constitutional features.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Left atrial myxoma. A pedunculated tumour attached to the interatrial septum can intermittently obstruct the mitral orifice, causing postural symptoms and a tumour plop.

Why is "Subacute infective endocarditis" not the answer?

Subacute endocarditis causes fever and a murmur but not postural obstruction or a posture-dependent sound.

Why is "Constrictive pericarditis" not the answer?

Constrictive pericarditis causes a pericardial knock and features of right-sided congestion, with no postural variation.

Why is "Rheumatic mitral stenosis" not the answer?

Rheumatic mitral stenosis gives a fixed opening snap and loud first sound without constitutional features.

What concept does this question test?

It tests Cardiology: left atrial myxoma in General Medicine. Constitutional features and a high ESR come from interleukin-6 release by the tumour. Echocardiography is diagnostic and treatment is surgical excision.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: left atrial myxoma?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.