Recommended Citation
Klimas C, Gamero Kubota P . Exercise Induced Raynaud's Phenomena in a Pediatric Patient. Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Abstract
Introduction/Background:
Although rare, cardiac myxomas can present with devastating symptoms including Raynaud's phenomena, stroke or even sudden death. It is important to rule out cardiac myxomas when evaluating a pediatric patient with vasooclusive symptoms. This case illustrates an example of a pediatric patient presenting with exercise induced Raynaud’s phenomena that was found to be due to a cardiac myxoma.
Description:
A 12-year-old female with a PMH of superficial angiomyxoma and subglottic infantile hemangioma presented to the ER for acutely worsening bilateral lower extremity pain in the setting of physical activity. She also endorsed episodic bilateral lower extremity pallor, paresthesia, and mild shortness of breath. She denied any chest pain, palpitations, or syncope. Prior to this presentation, she was found to have an elevated ESR and positive ANA. She recently had a CXR which showed no signs of cardiopulmonary pathology. She started oral steroids and was referred to as outpatient rheumatology. Prior to rheumatology consultation her symptoms continued to be more frequent with less activity which prompted her to present to the ED. Lower extremity vessel doppler imaging was reassuring with no signs of occlusion. However, during the initial evaluation, the patient was able to reproduce her symptoms with minimal activity, thus prompting more detailed vascular imaging. The patient underwent a CTA abdominal aorta with contrast which revealed a long segment of occlusion within the right anterior tibial artery. The patient was transferred to an OSH for urgent vascular surgery. During pre-op workup at the OSH, an echocardiogram was performed which revealed a large left atrial mass. To further delineate the mass, a cardiac MRI was performed which revealed a 4.9x.2.9x3.6 cm lobular mass. This was consistent with a cardiac myxoma. Given the size and location of the mass, emergency surgical resection was done. Pathology results are still pending.
Discussion:
Due to cardiac myxomas being rare within the pediatric population, a high degree of suspicion is required for accurate diagnosis. Outcomes of undiagnosed cardiac myxomas can result in significant life altering sequelae making prompt treatment imperative. Our patient had a PMH of vessel malformations with acutely worsening vasocclusive symptoms resulting in more detailed vascular imaging. As a result, a quick diagnosis was achieved, and the patient was able to receive proper treatment prior to any devastating outcomes.
Presentation Notes
Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Full Text of Presentation
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Document Type
Poster
Open Access
Available to all.
Exercise Induced Raynaud's Phenomena in a Pediatric Patient
Introduction/Background:
Although rare, cardiac myxomas can present with devastating symptoms including Raynaud's phenomena, stroke or even sudden death. It is important to rule out cardiac myxomas when evaluating a pediatric patient with vasooclusive symptoms. This case illustrates an example of a pediatric patient presenting with exercise induced Raynaud’s phenomena that was found to be due to a cardiac myxoma.
Description:
A 12-year-old female with a PMH of superficial angiomyxoma and subglottic infantile hemangioma presented to the ER for acutely worsening bilateral lower extremity pain in the setting of physical activity. She also endorsed episodic bilateral lower extremity pallor, paresthesia, and mild shortness of breath. She denied any chest pain, palpitations, or syncope. Prior to this presentation, she was found to have an elevated ESR and positive ANA. She recently had a CXR which showed no signs of cardiopulmonary pathology. She started oral steroids and was referred to as outpatient rheumatology. Prior to rheumatology consultation her symptoms continued to be more frequent with less activity which prompted her to present to the ED. Lower extremity vessel doppler imaging was reassuring with no signs of occlusion. However, during the initial evaluation, the patient was able to reproduce her symptoms with minimal activity, thus prompting more detailed vascular imaging. The patient underwent a CTA abdominal aorta with contrast which revealed a long segment of occlusion within the right anterior tibial artery. The patient was transferred to an OSH for urgent vascular surgery. During pre-op workup at the OSH, an echocardiogram was performed which revealed a large left atrial mass. To further delineate the mass, a cardiac MRI was performed which revealed a 4.9x.2.9x3.6 cm lobular mass. This was consistent with a cardiac myxoma. Given the size and location of the mass, emergency surgical resection was done. Pathology results are still pending.
Discussion:
Due to cardiac myxomas being rare within the pediatric population, a high degree of suspicion is required for accurate diagnosis. Outcomes of undiagnosed cardiac myxomas can result in significant life altering sequelae making prompt treatment imperative. Our patient had a PMH of vessel malformations with acutely worsening vasocclusive symptoms resulting in more detailed vascular imaging. As a result, a quick diagnosis was achieved, and the patient was able to receive proper treatment prior to any devastating outcomes.
Affiliations
Advocate Children’s Hospital