Stroke from A Large Left Atrial Myxoma (original) (raw)
Related papers
A case of large atrial myxoma presenting as an acute stroke
Journal of community hospital internal medicine perspectives, 2016
Left atrial myxomas are rare primary cardiac tumors. Their incidence is estimated to be about 0.1% of total cases. Neurological complications resulting from cardiac myxomas are seen in 20-35% of patients. Transesophageal echocardiogram (TEE) is preferred over transthoracic echocardiogram for evaluation of left atrial myxoma. Three-dimensional (3D) echocardiography ensures better visualization of intracardiac structures. It has been used prior to surgery for diagnostic support in the surgical treatment of cardiac masses. We present a case of a 46-year-old Hispanic male who developed acute ischemic stroke of left frontal lobe and was also found to have multiple 'silent' cerebral infarcts in the MRI of the brain. On further workup, he was found to have a left atrial myxoma on 3D TEE. This was resected with the assistance of intra-operative 3D TEE imaging. We present this case to increase awareness and to stress at early evaluation of secondary causes of ischemic cerebrovascular...
Left Atrial Myxoma with Ischemic Stroke Complications: A Case Report
Proceedings of the 3rd International Conference on Cardiovascular Diseases (ICCvD 2021), 2022
Cardiac myxoma is the most frequent primary tumor of the heart, considered a benign, slowly proliferating neoplasm. The incidence of cardiac myxoma is low, with approximately 0.5-1 cases per 1,000,000 individuals per year. Cardiac myxoma can be present at any age but most often in 30-60 years old, with female predominance (1.5:1). Serious complications include neurological symptoms, heart failure, arrhythmias, and pericardial effusion. Ischemic stroke complications associated with atrial myxoma due to embolus. Aims: to describe the features, complications and management of left atrial myxoma. Case summary: A 31-year-old woman with the chief complaint of sudden diplopia and syncope since 4 days before admission to the hospital. Patient also had history of recurrent vertigo in the last month. Her vital sign was normal. Neurological examination showed eyeball muscles paralysis (OD: nerve VI, IV and III inferior oblique paralysis; OS: nerve III medial and superior paralysis), flat right nasolabial plica (nerve VII right perifer paralysis) and tongue deviation to the right (nerve XII right central paralysis). A Head MRI showed subacute multiple infarcts in bilateral thalamus and bilateral centrum semiovale with infarcts in left cerebellum. Echocardiography showed a pedunculated mass in left atrium attached to the interatrial septum, which was suggestive of left atrial myxoma. Patient diagnosed a left atrial myxoma with ischemic stroke. Results: Excised left atrial myxoma was performed with cardiac surgery and cardiopulmonary bypass procedures. After treatment procedures, the patient have clinical improvement without any complications. Histopathological examination revealed cardiac myxoma. Follow-up echocardiography showed no residual tumors in left atrial. Conclusions: Echocardiography should be done in all cases of stroke as a screening tool to rule out any intracardiac mass, such as cardiac myxoma. Early diagnosis and urgent surgical excision of the cardiac myxoma remains the definitive treatment that will be given excellent results.
Acute ischemic stroke on the setting of left atrial myxoma: optimal time for cardiac surgery
Case Reports in Internal Medicine, 2021
The surgical resection timing of left atrial (LA) myxoma is still controversial in concern for the risk of further embolic phenomena if delayed surgery versus hemorrhagic transformation during early surgery. We describe a case of 60-year-old man without significant past medical history admitted with two-day of double vision and found to have LA myxoma. Multiple factors including clinical aspects and comorbidities should be evaluated to decide the favorable management.
Atrial myxoma as a cause of stroke: emboli detection and thrombolytic treatment
Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina, 2012
It presents a case of a 42-year-old female patient who was admitted to the stroke unit for right-sided hemiplegia and global aphasia, without conventional stroke risk factors. As the patient presented within the therapeutic time window and had no contraindications for thrombolysis, intravenous thrombolytic treatment was initiated. Brain CT showed multiple hypodense partly confluent lesions in the territory of the left middle cerebral artery. For the purpose of determining the etiology of the stroke, TCD was performed and after cerebral microemboli were detected, transthoracic echocardiography was indicated, the finding of which showed the presence of a myxoma in the left atrium. The patient underwent surgery and thereafter her neurological deficits improved.
Left Atrium Myxoma Revealed by an Ischemic Stroke: About a Case
Asploro Journal of Biomedical and Clinical Case Reports (ISSN: 2582-0370), 2019
Introduction: Left atrial myxoma is a rare benign tumor. It can be an embolic complication such as an ischemic stroke. Case presentation: It was a 48 years old patient who was referred to our unity for the etiological investigation of an ischemic stroke. She did not have personal medical and surgical history. She had a recent right hemiplegia. The cardiac auscultation found a mitral diastolic murmur. The brain CT showed a recent ischemic stroke in the superficial and deep left sylvian territory. The transthoracic echography revealed a myxomatous mass, responsible of an obstacle of the left ventricular filling. Anticoagulation by antivitamin K (AVK) had been initiated and a resection of the mass indicated. Conclusions: The left atrial myxoma is a rare benign tumor whose mode of revelation can be an embolic complication. The Echocardiography is reference imaging modality in diagnosis with a high sensitivity.
Cases Journal, 2008
A myxoma is the most common primary tumor of the heart. It has been reported as the source of a cardiogenic embolism. Therefore, it is important for clinicians to detect the myxoma early via echocardiography to prevent complications, such as syncope, sudden death, and cerebral embolic ischemic stroke. This report presents the case of a 54-year-old female whose clinical manifestation of atrial myxoma was an ischemic stroke. Atrial myxoma was later confirmed as the cause of her symptoms via transesophageal echocardiography.
Cardioembolic Stroke in Young: A Case of Atrial Myxoma Origin
Cureus
Stroke is one of the leading causes of mortality and disability. It can be rarely caused by cardiac myxoma. Sometimes stroke may be its first clinical manifestation. Here we report a case of posterior circulation stroke in left atrial myxoma. A 45-year-old female patient presented with a history of recurrent episodes of dizziness and headache of three months duration. Neurological examination showed impaired tandem gait. Magnetic resonance imaging (MRI) of the brain revealed infarction in the left posteroinferior cerebellar hemisphere. Echocardiography of the patient revealed a large left atrial mass suggestive of atrial myxoma and an ejection fraction of 60%. The patient was operated on for atrial myxoma two days after the diagnosis, and histopathology confirmed the diagnosis. Postoperatively she remained well and was managed on anti-platelet drugs. Atrial myxoma should be considered as a possible differential while evaluating a case of cardioembolic stroke, and echocardiography detects the presence of an atrial myxoma. It is also essential that atrial myxomas are managed early to prevent recurrent strokes.
Recurrent Ischemic Stroke in a Patient with Atrial Myxoma: A Case Report
Journal of Nepal Medical Association, 2022
Cardiac myxoma is an infrequent but curable cause of ischemic stroke. There are no guidelines addressing the timing of surgery to excise the tumour or for the use of thrombolysis or thrombectomy. We present a case with an ischemic stroke which was diagnosed to have atrial myxoma. She was planned for surgical excision of the tumour but suffered from a second ischemic stroke while awaiting surgery. This article aims to highlight vital aspects of this rare phenomenon and discuss the prospects of the timing of surgery and neurosurgical intervention. The importance of a proper cardiac evaluation in all cases of stroke is highlighted.
Stroke and recurrent peripheral embolism in left atrial myxoma
Acta Cardiologica, 2010
Primary cardiac tumours are uncommon, with an estimated incidence between 0.0017% and 0.19%. Cardiac myxoma is a rare cause of cerebrovascular disease, especially in children. This case report emphasizes the importance of cardiac evaluation, especially echocardiographic examination in cases with stroke and peripheral embolism.
A Rare Cause of Pediatric Stroke: Left Atrial Myxoma
We describe a case of sudden-onset left-sided hemiparesis and dysarthria in a five-year-old boy. Acute vascular malformation bleeding or ischemic stroke was suspected. Neurological examination three weeks after the initial event revealed mild residual facial paresis. Brain angiography ruled out a vascular malformation. A work-up echocardiogram revealed a 4-cm left atrial mass compatible with cardiac myxoma. Urgent surgical resection of the mass under cardiopulmonary bypass confirmed the diagnosis. Uneventful recovery followed surgical resection. In this report, we present a partially embolized left atrial myxoma that caused an acute ischemic stroke, which is rarely considered and encountered in the pediatric population.