Case Presentation A 65 year-old female with a past medical history of hypertension and diabetes presented to her cardiologist’s office with symptoms consistent with progressive heart failure over an eight month period. A transthoracic echocardiogram done in the office demonstrated a normal-appearing mitral valve and normal left ventricular systolic function. Additionaly, it also revealed a large left atrial myxoma (pictured above). The mass obstructed flow through the mitral valve, resulting in a mean valvular gradient of 18 mm Hg, consistent with mitral stenosis-like physiology. As a result of these findings, the patient was admitted to our institution for further evaluation. A transesophageal echocardiogram was performed for further assessment and showed a 6.7 x .6 cm homogenous mass which appeared to be attached by a stalk to the interatrial septum at the fossa ovalis. The patient subsequently underwent excision of this myxoma along with a patch repair of the interatrial septum. Postoperatively she was stable and discharged home six days later with surgical and cardiac follow-up. Discussion Benign myxomas are the most common tumors arising in the left atrium. Typically they are pedunculated and gelatinous in consistency with size varying from 1 to 15 centimeters. Cardiovascular manifestations largely depend on the anatomic location of the tumor, with 80% being found in the left atrium. Like our patient, ~70% of patients with left atrial myxoma suffer symptoms of heart failure, as well as syncopal episodes. Nearly 0% suffer from embolic events.1