Kardiologischer Fall: 42-jährige Frau mit Gelenkschmerzen, leichtem Fieber und Dyspnoe von Joseph Alpert, MD

A previously healthy 42-year-old woman presents with complaints of several weeks of diffuse joint discomfort, low-grade fever, and dyspnea. She reports that she recently fainted while standing up in her bedroom. She also noted that on one recent cold morning, her fingertips had turned white and became painful, which resolved when she placed her hands under warm water. She has no personal history of rheumatic fever as a child. On physical examination, she appears to be ill and uncomfortable, her blood pressure is 110/73 mm Hg, and her heart rate is 79 beats/min. On cardiac auscultation, a short, pre-systolic, low-pitched murmur is heard over the apex with the patient lying on her left side. Her ECG and chest X-ray results are normal. Which of the following is the best next step in diagnosis?

A previously healthy 42-year-old woman presents with complaints of several weeks of diffuse joint discomfort, low-grade fever, and dyspnea. She reports that she recently fainted while standing up in her bedroom. She also noted that on one recent cold morning, her fingertips had turned white and became painful, which resolved when she placed her hands under warm water. She has no personal history of rheumatic fever as a child. On physical examination, she appears to be ill and uncomfortable, her blood pressure is 110/73 mm Hg, and her heart rate is 79 beats/min. On cardiac auscultation, a short, presystolic, low-pitched murmur is heard over the apex with the patient lying on her left side. Her ECG and chest X-ray results are normal. An echocardiogram reveals a myxoma located in the left atrium. Which of the following is the most appropriate next step in management?