{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:34Z","timestamp":1753876234856,"version":"3.41.2"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T00:00:00Z","timestamp":1647302400000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Atrial myxomas (AMs) are the most commonly encountered cardiac tumours. They can be genetically inherited and are commonly found in the left atrium. They usually present with dyspnoea, syncopal episodes, heart failure from mitral valve obstruction, and constitutional symptoms including weight loss, fatigue, and fever. We present a rare case of severe symptomatic hyponatraemia secondary to a large AM and discuss possible aetiology.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 75-year-old Caucasian female presented with acute nausea, vomiting, confusion, and drowsiness. She had a background of palpitations for about 20\u2009years. Her blood test results revealed severe hyponatraemia (serum sodium\u2014103\u2009mmol\/L). Further investigations for hyponatraemia including serum cortisol and urine biochemistry suggested Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH) secretion. Computer tomography scan revealed an incidental large left AM. Echocardiography confirmed the AM attached to the left side of the inter-atrial septum and occupying the majority of the left atrium. She was treated medically for hyponatraemia and referred for excision of myxoma. She underwent urgent resection of the myxoma once sodium levels were optimized. Postoperatively, her serum sodium remained low but gradually returned to normal on postoperative Day 11.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This is only the third reported case of significant hyponatraemia associated with a large AM. It has been previously hypothesized that large left AM stretch the atrium causing release of atrial natriuretic peptide and subsequent hyponatraemia. The excision of myxoma and reduction in left atrial size postoperatively with an improvement in sodium levels suggests an association between the two pathologies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac111","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T12:52:01Z","timestamp":1647348721000},"source":"Crossref","is-referenced-by-count":0,"title":["Severe hyponatraemia in a patient with a large left atrial myxoma: a case report"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6657-3368","authenticated-orcid":false,"given":"Srushti","family":"Bhat","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Barts Heart Centre, St. Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3380-9554","authenticated-orcid":false,"given":"Wael I","family":"Awad","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Barts Heart Centre, St. Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,3,15]]},"reference":[{"year":"2021","author":"Atrial myxoma","key":"2022031805502275500_ytac111-B1"},{"journal-title":"BMJ Best Pract","article-title":"Yusuf SW. 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A series of 112 consecutive cases","volume":"80","author":"Pinede","year":"2001","journal-title":"Medicine (Baltimore)"},{"key":"2022031805502275500_ytac111-B4","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.jss.2012.06.004","article-title":"Preoperative hyponatraemia predicts outcomes after cardiac surgery","volume":"181","author":"Crestanello","year":"2013","journal-title":"J Surg Res"},{"key":"2022031805502275500_ytac111-B5","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.1152\/ajpendo.1988.254.1.E1","article-title":"Physiology and pathophysiology of atrial peptides","volume":"254","author":"Goetz","year":"1988","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"2022031805502275500_ytac111-B6","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/S0950-351X(89)80010-2","article-title":"Atrial natriuretic peptide: water and electrolyte homeostasis","volume":"3","author":"Kenyon","year":"1989","journal-title":"Baillieres Clin Endocrinol Metab"},{"key":"2022031805502275500_ytac111-B7","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1186\/cc9788","article-title":"Natriuretic peptide-induced Hyponatraemia in a patient with left atrial myxoma","volume":"15(Suppl 1","author":"Ramnarain","year":"2011","journal-title":"Crit Care"},{"key":"2022031805502275500_ytac111-B8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/00015385.2021.1918894","article-title":"Natriuretic peptide-induced hyponatraemia in a patient after surgical resection of a left atrial myxoma","author":"Andriessen","year":"2021","journal-title":"Acta Cardiol"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytac111\/42898957\/ytac111.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/3\/ytac111\/42951636\/ytac111.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/3\/ytac111\/42951636\/ytac111.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T06:13:13Z","timestamp":1647583993000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytac111\/6548800"}},"subtitle":[],"editor":[{"given":"Michael Pompeu","family":"S\u00e1","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Marcelo Haertel","family":"Miglioranza","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Laszlo","family":"Gobolos","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Matteo","family":"Parollo","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Nida","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,3,1]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytac111","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2022,3,1]]},"published":{"date-parts":[[2022,3,1]]},"article-number":"ytac111"}}