Clinical Problem-Solving: 72-Year-Old Woman With Multifocal Strokes and an Intracardiac Mass

Abstract

We present the case of a 72-year-old female with multifocal strokes found to have multiple, mobile intracardiac masses. We discuss the differential diagnosis and evaluation of intracardiac masses, and the challenges in management of the ultimately diagnosed etiology of stroke in this patient.

Keywords

cerebrovascular accident cardioembolism cardiac tumor vascular neurology fibroelastoma

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References

Fisher

. Lacures: small, deep cerebral infarcts. Neurology. 1965;15:774-784.

Jung

Devuyst

Maeder

Bogousslavsky

. Atrial fibrillation with small subcortical infarcts. J Neurol Neurosurg Psychiatry. 2001;70(3):344-349.

Bernatchez

Gaudreault

Vincent

, et al. Left atrial myxoma presenting as an embolic shower: a case report and review of literature. Ann Vasc Surg. 2018;53:266.e13-266.e20.

Sorour

Kurmann

El-Am

, et al. Recurrence of pathologically proven papillary fibroelastoma. Ann Thorac Surg. 2021;S0003-4975(21):00862-00866.

Paraskevaidis

Michalakeas

Papadopoulos

Anastasiou-Nana

. Cardiac tumors. ISRN Oncol. 2011;2011:208929.

Gowda

Khan

Nair

, et al. Cardiac papillary fibroelastoma: a comprehensive analysis of 725 cases. Am Heart J. 2003;146(3):404-410.

Park

Cho

Kim

, et al. Malignant lymphoma arising in cardiac myxoma, presenting with peripheral arterial emboli. Cardiovasc Pathol. 2018;32:26-29.

Tyebally

Chen

Bhattacharyya

, et al. Cardiac tumors: JACC CardioOncology state-of-the-art review. JACC CardioOncol. 2020;2(2):293-311.

Motwani

Kidambi

Herzog

Uddin

Greenwood

Plein

. MR imaging of cardiac tumors and masses: a review of methods and clinical applications. Radiology. 2013;268(1):26-43.

10.

Klarich

Enriquez-Sarano

Gura

Edwards

Tajik

Seward

. Papillary fibroelastoma: echocardiographic characteristics for diagnosis and pathologic correlation. J Am Coll Cardiol. 1997;30:784- 790.

11.

Sun

Asher

Yang

, et al. Clinical and echocardiographic characteristics of papillary fibroelastomas: a retrospective and prospective study in 162 patients. Circulation. 2001;103:2687-2693.

12.

Kondamareddy

Kerndt

Masood

. Lambls excrescences. [Updated 2021 Nov 26]. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2022.

13.

Tamin

Maleszewski

Scott

, et al. Prognostic and Bioepidemiologic Implications of Papillary Fibroelastomas. J Am Coll Cardiol. 2015;65:2420-2429.

14.

Meschia

Bushnell

Boden-Albala

, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:3754-3832.

15.

Devanabanda

Lee

. Papillary fibroelastoma. 2021 Aug 11. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2022.