Incidental Finding of an Exceptionally Large Left Atrial Myxoma Presenting as an Acute Cardioembolic Stroke

Bedoya, R; Smith, Trevor; Ma, Hoan; Goodner, Amy; Sreedhar, J

doi:10.7759/cureus.18056

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…They may locally invade surrounding heart or lung tissue, causing left ventricular dysfunction, arrhythmia, pericardial effusion and even cardiac tamponade. Again, the breakdown of tumor fragments or tumor thrombi can result in embolic manifestations, the most deadly manifestations of which are neurologic [4][5][6][7][8][9]. LA myxomas are slow growing tumors.…”

Section: Introductionmentioning

confidence: 99%

“…Fever and weight loss and deranged biochemical laboratory parameters (including anemia, increased globulins, increased erythrocyte sedimentation rate (ESR), increased C-Reactive protein (CRP)) are seen in about one-thirds of patients. On physical examination, a 'tumor plop' (a low-pitched diastolic sound immediately after S2) may be heard on auscultation, which is a giveaway [4,5].…”

Section: Introductionmentioning

confidence: 99%

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An unusual cause of acute ischemic cardioembolic stroke in a middle aged lady: An incidentally detected large Left Atrial Myxoma – A Case Report.

Bhattacharya

Bandyopadhyay

Pahari

et al. 2022

Preprint

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Introduction Primary cardiac tumors are rare but are surgically curable. Incidence of primary cardiac tumors varied between 0.0017% and 0.03 % in previous studies. Left atrial (LA) myxoma is the most common primary cardiac tumor, locally invading heart or lung tissue, causing left ventricular dysfunction, arrhythmia, pericardial effusion or cardiac tamponade. Again, tumor fragment breakdown or tumor thrombi can result in embolic manifestations, the most deadly manifestations being neurologic. Here we report an unusual cause of acute ischemic cardio-embolic stroke in a middle-aged lady, an incidentally detected large LA myxoma. Case presentation A 45-year-old hypertensive lady presented at the Emergency Department (ED) with acute onset aphasia, right facial droop, right sided hemiplegia and left sided subconjunctival haemorrhage. A large LA myxoma was incidentally detected through Transthoracic Echocardiography, which was the cause for the stroke. Excision of LA myxoma was done through a standard median sternotomy, under cardiopulmonary bypass, using the right atrial approach. Histopathology examination of the excised jelly-like mass confirmed it to be an LA myxoma. The patient has been doing well at a follow up period of six months. Conclusions Cardiac tumors are rare, but embolic complications can prove to be devastating, especially neurologic. A strong clinical suspicion followed by a thorough physical examination is mandatory as the history can often be misleading, with non-specific signs and symptoms. Trans-esophageal Echocardiography remains the gold standard for diagnosis. Once detected, the tumor needs to be excised at the earliest to prevent further complications.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An unusual cause of acute ischemic cardioembolic stroke in a middle aged lady: An incidentally detected large Left Atrial Myxoma – A Case Report.

Bhattacharya

Bandyopadhyay

Pahari

et al. 2022

Preprint

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Safety and Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke Attributable to Cardiological Diseases: A Scoping Review

D’Anna,

Abu‐Rumeileh,

Merlino

et al. 2024

JAHA

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There is limited evidence on the outcomes and safety of mechanical thrombectomy (MT) among patients with acute ischemic stroke (AIS) in the context of cardiac diseases. Our study reviews MT in AIS within the context of cardiac diseases, aiming to identify existing and emerging needs and gaps. PubMed and Scopus were searched until December 31, 2023, using a combination of cardiological diseases and “mechanical thrombectomy” or “endovascular treatment” as keywords. Study design included case reports/series, observational studies, randomized clinical trials, and meta‐analyses/systematic reviews. We identified 943 articles, of which 130 were included in the review. Results were categorized according to the cardiac conditions. MT shows significant benefits in patients with atrial fibrillation (n=139) but lacks data for stroke occurring after percutaneous coronary intervention (n=2) or transcatheter aortic valve implantation (n=5). MT is beneficial in AIS attributable to infective endocarditis (n=34), although functional benefit may be limited. Controversy surrounds the functional outcomes and mortality of patients with AIS with heart failure undergoing MT (n=11). Despite technical challenges, MT appears feasible in aortic dissection cases (n=4), and in patients with left ventricular assist device or total artificial heart (n=10). Data on AIS attributable to congenital heart disease (n=4) primarily focus on pediatric cases requiring technical modifications. Treatment outcomes of MT in patients with cardiac tumors (n=8) vary because of clot consistency differences. After cardiac surgery stroke, MT may improve outcomes with early intervention (n=13). Available data outline the feasibility of MT in patients with AIS attributable to large‐vessel occlusion in the context of cardiac diseases.

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Incidental Finding of an Exceptionally Large Left Atrial Myxoma Presenting as an Acute Cardioembolic Stroke

Abstract: Bedoya et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 2 publications

References 12 publications

An unusual cause of acute ischemic cardioembolic stroke in a middle aged lady: An incidentally detected large Left Atrial Myxoma – A Case Report.

An unusual cause of acute ischemic cardioembolic stroke in a middle aged lady: An incidentally detected large Left Atrial Myxoma – A Case Report.

Safety and Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke Attributable to Cardiological Diseases: A Scoping Review

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