Characterizations of Ischemic Stroke Complications in Cardiac Myxoma Patients at a Single Institution in Eastern China

Zhang, Yanlei; Ye, Zusen; Fu, Yun Ching; Zhang, Zheng; Qiang, Yong; Chen, Feichi; Cheng, Jianhua

doi:10.2147/ndt.s280641

Cited by 8 publications

(6 citation statements)

References 19 publications

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“…Причем источником ТЭЛА могли быть эмболы -частички миксомы правого предсердия [12]. Так, по данным Y. Zhang с соавт., клинические проявления эмболии наблюдаются у 10 % пациентов с миксомой правого предсердия [13][14][15].…”

Section: Discussionunclassified

Chronic thromboembolic pulmonary hypertension in a patient with myxoma of the heart and thrombophilia of mixed genesis

Okorokov,

Evsina,

Fomina

et al. 2024

Klinicist

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Objective. To describe the clinical case of a young patient with chronic thromboembolic pulmonary hypertension (CTEPH) with heart myxoma and thrombophilia of mixed origin, who underwent surgical treatment.Materials and methods. Patient Z., 24 years old, was admitted to the cardiology department with cough with sputum production that occurs during physical activity, including streaks of blood, shortness of breath with slight physical exertion, legs and feets edema, weakness and dizziness. The examination was carried out: electrocardiography; multislice computed tomography pulmonary angiography; echocardiography (EchoCG); transesophageal EchoCG; magnetic resonance imaging of the heart with contrast; screening for coagulopathy.Results. Based on clinical data, medical history, laboratory, instrumental diagnostic, we have put the diagnosis: Myxoma of the right atrium. Patent foramen ovale. Thrombophilia of mixed origin: hereditary – heterozygous mutation of the prothrombin gene (factor 2), acquired – hyperhomocysteinemia. Postthrombotic deep vein disease of the left lower limb. Recurrent pulmonary embolism (last relapse dated October 19, 2022). CTEPH functional class III (World Health Organization), moderate risk. Congestive heart failure with reduced right ventricular ejection fraction, functional class III (by the New York Heart Association). Relative tricuspid valve regurgitation grade 3. The patient underwent surgery: thromboendarterectomy from the right pulmonary artery under conditions of circulatory arrest and deep hypothermia, removal of a right atrium myxoma under conditions of artificial circulation and blood cold cardioplegia: tricuspid valve plasty according to De Vega. After surgery patient’s condition was significantly improved.Conclusion. The features of diagnosis and treatment of a patient suffering from CTEPH and cardiac myxoma are outlined. Surgery: Pulmonary thrombectomy and cardiac myxoma removal may improve the patient’s condition with CTEPH and left atrial myxoma.

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Section: Discussionunclassified

Chronic thromboembolic pulmonary hypertension in a patient with myxoma of the heart and thrombophilia of mixed genesis

Okorokov,

Evsina,

Fomina

et al. 2024

Klinicist

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“…Tumors smaller than 3 cm are associated with a higher risk of embolic events involving cerebral infarctions [ 6 ]. Embolization of myxomatous tissues is seen in approximately 50% of patients and can affect multiple organs, including the kidneys, spleen, and central nervous system.…”

Section: Discussionmentioning

confidence: 99%

“…Embolization from cardiac myxoma mainly involves the middle cerebral artery territory, including the parietal region, temporal region, and basal ganglia. Common presenting symptoms include hypoesthesia, hemiparesis, and facial paresis [ 6 ]. Involvement of PICA territory infarcts is not as common and presents with acute vertigo, vomiting, headache, gait disturbances, and horizontal nystagmus ipsilateral to the lesion, with headache being the most common initial symptom.…”

Section: Discussionmentioning

confidence: 99%

Global Transient Amnesia as the Predominant Symptom of Cardiac Myxoma: A Case Report

et al. 2022

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Unusual clinical course Background:The most common neurological symptoms from cardiac myxoma-induced stroke include territories of middle cerebral arteries, rendering posterior stroke less common. Although transient global amnesia usually has a benign prognosis, amnesia in the setting of concerning cerebellar symptoms should raise the suspicion for posterior circulation involvement. These benign-appearing symptoms can be manifestations of an acute cerebrovascular accident (CVA). This unusual presentation can delay workup for underlying pathology. Case Report:A 67-year-old woman presented to the local emergency department after an episode of global amnesia that lasted about 15 minutes and was associated with some dizziness. The patient also reported a history of chronic disequilibrium. The head CT scan was negative for any acute findings. A follow-up MRI of the brain demonstrated acute small lacunar infarcts within the left cerebellum and right parietal lobe. An echocardiogram was performed due to concern for the cardioembolic source, which revealed left atrial myxoma. She was transferred to a tertiary center for immediate surgical intervention due to the high risk of embolization associated with the condition. The patient subsequently underwent successful surgical excision of the lesion. Conclusions:Cardiac myxoma, although a rare cause of posterior stroke, needs prompt intervention as it is associated with a high risk of systemic embolization, including recurrent CVA. Transient global amnesia is an atypical presentation of cardiac myxoma that can easily be overlooked, delaying timely diagnosis and prompt intervention.Early recognition and surgical resection are crucial to prevent potentially life-threatening consequences.

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“…Once diagnosed, management of cardiac myxoma should be early and complete to avoid serious complications such as an ischemic stroke, amnesia, myocardial infarction, syncope, sudden death, and possible fatal relapse [14,16]. Surgery is the treatment of choice for the complete removal of the tumor [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39].…”

Section: Image 1 Cerebral Ct Scan Showed Cerebral Ischemia Localized ...mentioning

confidence: 99%

Left Atrial Myxoma Revealed by a Stroke in a Young Female Patient

Charfo Bacharou M.,

Boutar Sidi M.,

Anas

et al. 2023

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Introduction: Cardiac myxoma is a primary benign tumor most often located in the left atrium and it is a rare source of cerebral stroke of young subjects. Case Presentation: We report the case of a young women with cardiac myxoma revelated by hemiplegia. The patient suddenly presented vertigo followed by a fall, a heaviness of her left body, and dysarthria. Brain CT tomography and magnetic resonance imaging revealed cerebral ischemia in the right Sylvian territory. Transthoracic echocardiography revealed a round cardiac mass, mobile, heterogeneous, multilobed, appended to the interatrial septum and the atrial side of the large mitral valve by wide implantation, measuring 38 x 25mm in the parasternal short axis (PSAX) and apical 4 chamber views evocative of left atrium myxoma. After the surgical resection, which was postponed for a month, the removed tumor was sent for histopathological examination. The morphological examination revealed a myxoid tumor proliferation compatible with cardiac myxoma expressing calretinin by these tumor cells in the immunohistochemical study. Conclusion: Left atrium myxoma is a benign cardiac tumor and a rare cause of ischemic stroke. Transthoracic echocardiography facilitates the diagnosis of this tumor which will then be confirmed by histological analysis.

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Characterizations of Ischemic Stroke Complications in Cardiac Myxoma Patients at a Single Institution in Eastern China

Cited by 8 publications

References 19 publications

Chronic thromboembolic pulmonary hypertension in a patient with myxoma of the heart and thrombophilia of mixed genesis

Chronic thromboembolic pulmonary hypertension in a patient with myxoma of the heart and thrombophilia of mixed genesis

Global Transient Amnesia as the Predominant Symptom of Cardiac Myxoma: A Case Report

Left Atrial Myxoma Revealed by a Stroke in a Young Female Patient

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