Patient History: This 17 years old boy presented to us with 2 months history of shortness of breath and intermittent fever. His clinical examination revealed that he did have tachycardia, signs of right sided heart failure with bilateral pleural effusions. EKG was low voltage with right atrial enlargement. Echocardiogram was done which showed a large echogenic mass extending from right atrium to right ventricle and also in inferior vena cava. Pulmonary artery pressures and pulmonary valve was normal but tricuspid valve was not visible due to large mass. There was also thrombus in inferior vena cava. Left sided chambers and valves were normal. Patient went under open heart excision of tumor, with repair of tricuspid valve and atrial septum. Biopsy revealed diagnosis of atrial myxoma.Patient is currently doing well.

Discussion: Myxoma is three times more commonly seen in the left atrium compared to the right. A ventricular location is very unusual. To our knowledge such a large tumor with involvement of much of atrium and ventricle has never been reported. And especially on right side with AV valve obstruction.