A critical cough

In winter 2012, I saw a 22 year old male NYU student. He went on a retreat with his parents but couldn’t ski because shortness of breath and coughing. His mother called and told me about this. I said “bring him right in when you come back”.

When they came in, he looked terrible and like he was losing a lot of weight. Previous doctors seemed to suggest he had a murmur. When I put him on the examining table (upright), his pulse was 180 and had a loud foghorn mitral regurgitation murmur. When I laid him flat, his pulse dropped to 120.  Within five minutes, I knew the diagnosis.

He had a tumor in his heart called “left atrial myxoma”. When sat upright, the tumor was sitting on his mitral valve and not letting blood go through (resulting in 180 pulse). Lying him flat revealed the left atrial had a stalk on it and allowed the tumor to move off of the mitral valve (causing his heart to be at 120, to get blood through and provide homeostasis).

Emotionless, I instructed his mom to take him to Baptist Hospital immediately. The cardiologist called me back after doing an echo cardiogram and said “this is the biggest left atrial myxoma I ever saw”. He was operated on (that afternoon) by a cardiothoracic surgeon, who removed the tumor through a scope.

Voila, he was cured.

In 2023, he got married and spearheaded a company.

This event was published in several journals (including Baptist Hospital’s Resource Magazine). It was called “The critical cough” and was the second best diagnosis I ever made.

Clearly saved his life.