Stroke and recurrent peripheral embolism in left atrial myxoma (original) (raw)
Related papers
Cerebral embolism complicating left atrial myxoma: a case report
Pan African Medical Journal, 2016
Cardiac myxoma are the most common benign primary cardiac tumors that can lead to many complications as described in literature. Here we report the case of a boy aged 11 that was referred for etiological diagnosis of ischemic stroke. Transthoracic echocardiography reveals a myxoma in the left atrium. Patient was referred to surgery. The diagnosis was confirmed and the mass was completely resected.
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.
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.
Hormozgan Medical Hournal, 2020
Introduction: Cardiac myxomas are the most common primary tumors of the heart with high embolic potential. Case Presentation: We present a young man with progressing stroke and atrial myxoma in an unusual site from the left upper pulmonary vein. Conclusions: Intravenous (IV) thrombolysis can be safe in patients with intracardiac myxoma and CNS embolization after good case selection. However, further studies are needed for better decision-making.
Cor et Vasa
SOUHRN U desetiletého dítěte došlo k rozvoji námahové synkopy, jíž předcházely bolest na hrudi a palpitace. Fyzikální vyšetření nepřineslo žádné zvláštní nálezy až na diastolický roll v oblasti mitrální chlopně. Iniciální elektrokardiogram prokázal komorovou tachykardii úspěšně zrušenou kardioverzí. Kontrola úpravy elektrické aktivity srdce prokázala rozsáhlý přední infarkt myokardu. Emergentní dopplerovské echokardiografi cké vyšetření prokázalo dilataci levé komory, akinetické apikální a střední segmenty anterolaterální stěny a srdečního hrotu se sníženou ejekční frakcí na 35 %. Hmota vyplňující téměř celou levou síň připomínala myxom. Angiografi cké vyšetření hrudníku a koronárních tepen diagnózu potvrdilo; rovněž prokázalo ischemii přední stěny a nepostižené koronární tepny. Konečná diagnóza zněla myxom levé síně komplikovaný koronární embolií. Byla provedena chirurgická resekce; následné histopatologické vyšetření diagnózu potvrdilo. Rešerše literatury o myxomech levé síně komplikovaných koronární embolií u dětí, kterou jsme provedli pro účely tohoto článku, prokázala, že uvedená kombinace se sice vyskytuje vzácně, je však závažná a vyžaduje značné zkušenosti, aby bylo možno stanovit správnou diagnózu a léčbu neodkládat.
Pathology International, 2003
Nonfamilial myxoma occurs as a random event. The tumor is rare and can mimic other diseases. Cardiac myxomas should always be considered as a source of embolization, which need meticulous investigation and prompt indication of surgical resection. Tumors with a villous surface are prone to embolize. We report two cases of cardiac myxoma presenting as acute ischemia of one or two limbs due to embolic phenomena. The patients were females aged 55 and 37 years. Histological study of emboli taken from obstructed limb arteries in the two patients showed a picture indicating systemic embolization of a cardiac myxoma. The embolic tissue fragments showed the gross characteristics (i.e. villous surface) of the cardiac tumor. Further echocardiography and surgical removal confirmed the cardiac myxoma. Immunohistochemical study of embolectomy material disclosed strong reactivity of the tumor cells for calretinin. The histological examination of the embolectomy material can anticipate the cardiac lesion and its gross features. Calretinin is a useful marker in the differential diagnosis of cardiac myxoma with a myxoid thrombus. The necessity of histological examination of the embolectomy material is stressed.
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.
Atrial Myxoma as a Cause of Stroke in the Young
Journal of Evidence Based Medicine and Healthcare, 2015
Cardiac Myxoma is a source of emboli to the CNS and elsewhere in the vascular tree. However non-specific systemic symptoms and minor embolic phenomenon may be overlooked in the absence of any history of cardiac symptoms. In this situation cardiac investigations may not be performed and diagnosis of this condition may be delayed until the onset of more significant embolic disease such as stroke with functional impairment as reported here.
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.
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.