Introduction: Primary heart tumors are rare, and among them myxoma is the most common. Symptoms of congestive heart failure are the most common manifestation, and embolization of the coronary artery is an extremely rare manifestation. (1)

Case report: 65-year-old male, with already known arterial hypertension, dyslipidemia, and chronic obstructive pulmonary disease (COPD) was admitted due to the subacute myocardial infarction with an elevation of the ST segment in inferior leads that lasted for approximately 24 hours. Emergency echocardiography showed a mass sized 5.4 x 4.0 cm in the left atrium, with myocardial echogenicity, attached to the interatrial septum with a stalk that floated with its edge through the mitral valve. It also showed a hypokinesis of the inferior left ventricle wall. The patient was highly febrile, but with sterile blood cultures. The possibility of the endocarditis of the mitral valve was excluded, and the febricity explained by an infective exacerbation of COPD. Antimicrobial, bronchodilatational, diuretic and other supportive therapies were implemented, and only after a complete clinic stabilization coronography was executed. An occlusion of the distal segment in the circumflex artery was found, without other significant stenosis. The diagnosis of left atrium myxoma with the embolization into the circumflex coronary artery was made, and the patient was moved into the Department of Cardiac Surgery in the Clinical Hospital Dubrava in Zagreb, where a successful excision was executed. The patient was discharged after a successful recovery.

Conclusion: This clinical case shows the necessity and value of an early bedside echocardiography with a clinical picture of acute and especially subacute myocardial infarction whenever possible.