A patient is failure and he develops sudden rash and has... Fever and

A patient is failure and he develops sudden rash and has... Fever and history of weight loss. What is the diagnosis?

Reading File

Finding Sources

Reading File

Finding Sources

This confirms the diagnosis clearly. The textbook directly links all three features together under atrial myxoma.

Diagnosis: Atrial Myxoma

The classic triad in this question is:

Feature	Explanation
Heart failure	The myxoma obstructs blood flow (commonly the mitral valve orifice), causing symptoms mimicking mitral stenosis and heart failure
Sudden rash	Due to peripheral emboli from tumor fragments or associated immune complex deposition
Fever + weight loss	Constitutional/systemic symptoms from cytokine release (especially IL-6) by the tumor

Why Atrial Myxoma?

Atrial myxoma is the most common primary cardiac tumor. It classically presents with a triad of:

Obstructive symptoms - dyspnea, orthopnea, heart failure, syncope (mimics mitral stenosis)
Embolic phenomena - stroke, peripheral emboli, rash from cutaneous emboli
Constitutional symptoms - fever, weight loss, myalgias, arthralgias, elevated ESR/CRP

A characteristic auscultatory finding is a "tumor plop" - an early diastolic sound as the pedunculated tumor prolapses through the mitral valve.

Diagnosis

Echocardiography (transthoracic or transesophageal) is the investigation of choice and confirms the diagnosis by visualizing the intracardiac mass.

Lab Findings

Elevated ESR, CRP
Elevated IL-6 (drives the constitutional symptoms)
Anemia, leukocytosis

Treatment

Surgical excision is the definitive treatment - urgent, given the risk of sudden death from valvular obstruction or massive embolism.

Source: Frameworks for Internal Medicine - "How common is fever in patients with atrial myxoma?" - "Fever is present in around one-third of patients with atrial myxoma. Other manifestations include syncope, heart failure, peripheral or pulmonary emboli, weight loss, myalgias, arthralgias, and rash."

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