Enigma of recurrent strokes with literature review

Abstract

Metastatic tumors are the most common tumors affecting the heart. Primary tumors are rare, with myxomas being the most common of the primary cardiac tumors. The incidence of primary cardiac tumors is 0.02%, about 200 cases has been reported in 1 million autopsies. Most of primary cardiac tumors have been detected incidentally on diagnostic modalities: computed tomography (CT), cardiac magnetic resonance imaging (MRI), or echocardiography. Majority of primary-origin cardiac tumors are benign, of which the most common type of primary tumor is cardiac myxoma. Fibroelastoma is a rare benign tumor and the 2nd most common cause of primary cardiac tumors. In the past fibroelastoma has been detected on autopsy findings. With the development of more advanced imaging modalities fibroelastoma is more frequently detected as a cause of stroke, myocardial infarction (MI), angina episodes, and systemic embolization. Echocardiogram is the best diagnostic modality to diagnose primary cardiac tumors although transthoracic echocardiogram (TTE) can miss primary cardiac tumors; transesophageal echocardiography (TEE) has been more labeled more accurate in the diagnosis of primary cardiac tumors. We present here a case of a 21-year-old male with the history of multiple strokes secondary to cardiac papillary fibroelastoma (CPF).

Statin therapy associated with decreased neuronal injury measured by serum S100β levels in patients with acute ischemic stroke

“…This novel effect of statins is actually is part of the wide neuroprotective enigma of statins. [ 47 ]…”

The Role of Transcranial Doppler Monitoring in Patients with Multi‐Territory Acute Embolic Strokes: A Review

“…The risk of embolism is related to irregular surface, atypical location, and increased mitotic index of the mass . Cardiac tumors, and in particular myxomas, may manifest as recurrent strokes, especially when not identified promptly . Resection of the tumor effectively eliminates the embolic potential .…”

“…122 Cardiac tumors, and in particular myxomas, may manifest as recurrent strokes, especially when not identified promptly. 123,124 Resection of the tumor effectively eliminates the embolic potential. 125 A case report of a patient with stroke attributed to cardiac myxoma failed to identify MES on TCD monitoring, suggesting that embolization might be a spontaneous event rather than a continuous phenomenon.…”