Cardiac papillary fibroelastoma: The need for a timely diagnosis

Yandrapalli, Srikanth; Mehta, Bella; Mondal, Pratik; Gupta, Tanush; Khattar, Pallavi; Fallon, John T.; Goldberg, Randy; Sule, Sachin; Aronow, Wilbert S.

doi:10.12998/wjcc.v5.i1.9

Cited by 18 publications

(20 citation statements)

References 6 publications

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“…3 Other life-threatening cardiac and neurological manifestations-including angina, syncope, blindness, myocardial infarction, sudden death, and heart failure-have been reported. 11 Dyspnea is not a typical symptom of CPF. 12 It is likely even more uncommon when valvular structures and blood flow are not obviously impeded.…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Papillary Fibroelastoma Presenting with Dyspnea on Exertion

Klerk

Dogon

Grossman

et al. 2020

CASE

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Section: Discussionmentioning

confidence: 99%

Left Ventricular Papillary Fibroelastoma Presenting with Dyspnea on Exertion

Klerk

Dogon

Grossman

et al. 2020

CASE

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“…It may be seen in every valve, from the aortic (35%-63%) to the pulmonary (0.5%-8%). Its frailty and mobility may lead to fatal or non-fatal embolization [20].…”

Section: Discussionmentioning

confidence: 99%

Sudden cardiac death and valvular pathology

Gouveia¹,

Gonçalves²

2019

Forensic Sciences Research

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Sudden death due to valvular heart disease is reported to range from 1% to 5% in native valves and around 0.2%-0.9%/year in prosthesis. The nature of the diseases is varied, from heritable, congenital to acquired. It may affect both genders in multiple age groups. The authors show and comment examples of the major nosologic aetiologies underlying unexpected exitus letalis of valvular nature. ARTICLE HISTORY

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“…Cardiac PFE are the second most common primary cardiac tumors (10%) 1,3 after myxomas. 1,2,4 Most PFE are found incidentally, but when they are symptomatic, stroke or TIA is the most common clinical presentation. 2,5 Echocardiogram usually demonstrates a small (≤1 cm) mobile mass arising from the mitral valve (less frequently from the aortic or tricuspid valve or auricular or ventricular surface), with a frayed pattern near the edges, correlated with the papillary projections of the tumor.…”

Section: Discussionmentioning

confidence: 99%

Papillary fibroelastoma, an unexpected cause of stroke

et al. 2018

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We present 3 cases of cardiac papillary fibroelastoma (PFE) revealed by acute ischemic stroke (table). Case 1 is a 38-year-old man who presented with sudden expressive language disorder and right hemiparesis. CT angiography showed a left middle cerebral artery (MCA) occlusion. Acute reperfusion therapy with endovascular thrombectomy (EVT) was achieved successfully. He was monitored in a stroke unit. The aspirated tissue was macroscopically congruent with a fibrin clot but the material was insufficient for pathologic analysis. A brain MRI performed a few days after admission showed a subacute ischemic stroke (figure, A). Blood tests, including hypercoagulability and autoimmunity assays, were normal or negative. Serial EKG and EKG Holter showed sinus rhythm. Transthoracic echocardiography (TTE) revealed an intracardiac mobile mass, with no history of fever or general malaise and negative blood cultures, suggestive of a primary cardiac tumor. Transesophageal echocardiography (TEE) (figure, B) confirmed the presence of an 11-mm pediculate mass bulging from the auricular surface of the mitral valve, with no valve or cardiac dysfunction. The suspicion of a primary cardiac tumor was supported. Case 2 is a 64-year-old man who presented with sudden left hemiparesis and dysarthria. CT angiography showed a right MCA occlusion. Endovascular acute reperfusion was attempted, but when the arteriography was performed, there had been a distal migration of the thrombus. He was monitored in a stroke unit. A brain MRI showed an established stroke (figure, A). Blood tests and EKG Holter were normal. TTE showed a pediculate mobile mass on the mitral valve. TEE (figure, B) confirmed its presence, 14 mm, in absence of valve dysfunction. There was no history of fever, raising the suspicion of a primary cardiac tumor. Case 3 is a 73-year-old man who presented with sudden expressive language disorder and right hemiparesis. There was no established stroke or arterial occlusion on CT scan/CT angiography. IV alteplase (recombinant tissue plasminogen activator [rtPA]) was administered in a stroke unit, with a good response. The brain MRI demonstrated a left temporoparietal stroke (figure, A). Blood tests were normal. Serial EKG and EKG Holter showed sinus rhythm. TTE revealed an auricular mass. TEE (figure, B) defined a 9-mm pediculate mass with frayed edges bulging from the left atrial appendage, suggestive of a primary cardiac tumor. There was no cardiac dysfunction.

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Cardiac papillary fibroelastoma: The need for a timely diagnosis

Cited by 18 publications

References 6 publications

Left Ventricular Papillary Fibroelastoma Presenting with Dyspnea on Exertion

Left Ventricular Papillary Fibroelastoma Presenting with Dyspnea on Exertion

Sudden cardiac death and valvular pathology

Papillary fibroelastoma, an unexpected cause of stroke

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