Atrial Heart Tumors and Hormonal Disruption: When the Heart Affects the Mind

By SWA

Introduction

A tumor in the atrium of the heart, even if benign, can have profound effects on the hormonal, electrolyte, and neurological systems. While cardiac tumors are rare, one particular type — the atrial myxoma — is the most common benign tumor of the heart. Such tumors can interfere with the production and regulation of atrial natriuretic peptide (ANP), a hormone critical for controlling blood pressure, salt levels, and water balance.

1. Diagnosis: CT Heart Scan Reveals Atrial Tumor

A cardiac CT (computed tomography) can reveal the presence of a tumor in the atrium, often missed by conventional echocardiography due to:

  • Small size

  • Atypical anatomical location

  • Imaging limitations

The atria (upper chambers of the heart) collect blood returning from the body (right atrium) or lungs (left atrium). Tumors here can mechanically compress or stretch atrial tissue, affecting normal cardiac hormone release.

2. Atrial Natriuretic Peptide (ANP): Hormone of the Heart

What is ANP?

Atrial natriuretic peptide (ANP) is a hormone secreted by atrial muscle cells in response to increased pressure or stretching of the atrial walls. It acts to reduce blood volume and pressure by promoting:

  • Sodium excretion (natriuresis)

  • Water excretion (diuresis)

  • Vasodilation

  • Inhibition of renin-angiotensin-aldosterone system (RAAS)

Reference:

3. Pathological ANP Overproduction: Tumor-Induced Hyponatremia and Water Intoxication

If a tumor increases atrial pressure or itself produces ANP, it can cause a dangerous overproduction of this hormone.

Consequences:

  • Excess sodium loss (hyponatremia)

  • Retention of free water → water intoxication (hypo-osmolar state)

  • Electrolyte imbalance

Symptoms:

  • Headache

  • Nausea

  • Muscle weakness

  • Confusion

  • In severe cases: seizures, coma

Reference:

4. Neuropsychiatric Symptoms from Hyponatremia

Hyponatremia affects the osmotic balance of the brain, causing water to enter neurons, potentially leading to cerebral edema.

Psychological manifestations may include:

  • Irritability

  • Mood swings

  • Depression

  • Anxiety or emotional lability

  • Delirium or hallucinations

These may mimic primary psychiatric disorders, but they are in fact secondary to metabolic imbalance.

Reference:

5. Preoperative Stabilization: Medications to Correct Hormonal Imbalance

Before any intervention, the patient is typically stabilized using:

  • Hypertonic saline solutions

  • Fluid restriction

  • Vasopressin antagonists (e.g., Tolvaptan)

  • Electrolyte monitoring

The goal is to restore sodium levels and prevent cardiovascular instability during tumor removal.

Reference:

6. Tumor Removal: Minimally Invasive Catheter-Based Procedure

In suitable cases, the tumor can be removed via transcatheter techniques, avoiding open-heart surgery. This minimally invasive approach reduces risk and speeds recovery, provided the tumor is accessible via this method.

Reference:

7. Postoperative Outcome: Rapid Normalization of Physiology and Mood

Once the tumor is removed and ANP levels return to normal, the following improvements are typically observed:

  • Electrolyte balance restored

  • Blood volume and pressure stabilize

  • Neurological and emotional symptoms resolve

  • Reduced risk of recurrence with full excision

Summary

AspectDescription
ConditionAtrial cardiac tumor (e.g., myxoma)
Hormonal ImpactOverproduction of ANP → Hyponatremia + water intoxication
Psychological SymptomsConfusion, mood swings, irritability, delirium
Diagnosis ToolsCardiac CT, possibly missed by echocardiography
TreatmentFluid/electrolyte correction, followed by minimally invasive tumor removal
PrognosisExcellent with complete removal and proper preoperative stabilization

Blood Tests: ANP and Related Biomarkers

https://swaresearch.blogspot.com/2025/06/blood-tests-anp-and-related-biomarkers.html

References

  1. American Heart Association – Cardiac Tumors Overview

  2. National Center for Biotechnology Information – Atrial Natriuretic Peptide (ANP)

  3. New England Journal of Medicine – Hyponatremia and the Brain

  4. The Lancet Neurology – Neuropsychiatric symptoms in electrolyte imbalance

  5. JAMA – Tolvaptan and Hyponatremia

  6. Cleveland Clinic – Cardiac Myxoma Surgery

© 2000-2025 Sieglinde W. Alexander. All writings by Sieglinde W. Alexander have a fife year copy right. Library of Congress Card Number: LCN 00-192742

 

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