## Core Concept
Myxomas are the most common type of primary cardiac tumors, often found in the left atrium. They can cause a variety of clinical symptoms due to their location and potential to embolize. Understanding the typical presentations of myxomas is crucial for diagnosis.

## Why the Correct Answer is Right
Myxomas can present with symptoms related to obstructive effects (e.g., heart failure symptoms), embolic phenomena (e.g., stroke, limb ischemia), or constitutional symptoms (e.g., fever, weight loss). The correct answer will highlight a feature not typically associated with myxomas.

## Why Each Wrong Option is Incorrect
- **Option A:** Constitutional symptoms such as fever, weight loss, and fatigue are commonly seen in patients with myxomas. These symptoms can occur due to the tumor itself or due to embolic events.
- **Option B:** Embolic events are a well-known complication of cardiac myxomas. Tumor fragments or associated thrombi can break off and travel to distant sites, leading to ischemia or infarction.
- **Option C:** Obstructive symptoms, such as those mimicking mitral stenosis (e.g., shortness of breath, edema), can occur if the tumor is large enough to impede blood flow through the heart chambers.
- **Option D:** While myxomas can lead to increased levels of certain inflammatory markers, significant **hypocalcemia** is not typically listed among the common clinical features of myxomas. Myxomas are more commonly associated with systemic symptoms like fever and weight loss rather than specific electrolyte imbalances like hypocalcemia.

## Clinical Pearl / High-Yield Fact
A key clinical feature that might help in diagnosing a myxoma is the **"tumbling mass"** observed on echocardiography, which describes the movement of the tumor within the heart chamber. This finding is quite characteristic and can help differentiate myxomas from other cardiac masses.

## Correct Answer: D.