Cerebral ischemia as initial neurological manifestation of atrial myxoma: case report

Almeida, Lucas Ferreira de; Hueb, João Carlos; Silva, Marcos Augusto de Moraes; Bazan, Rodrigo; Estrozi, Bruna; Raffin, César N.

doi:10.1590/s0004-282x2006000400027

Cited by 7 publications

(9 citation statements)

References 16 publications

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“…These data are compatible with literature sources pointing to the simultaneous appearance of multiple emboli at different target sites in patients presenting with cardiac myxomas. 68 Another line of evidence supporting our data is the large number of silent lesions commonly found in patients with stroke and myxomas, 69 as in the case of the patient presented here. Thus, it seems that in many cases, despite silent embolic events, the patient may remain clinically intact for years until a symptomatic event occurs.…”

Section: Discussionsupporting

confidence: 78%

Microemboli monitoring by trans-cranial doppler in patient with acute cardioemboliogenic stroke due to atrial myxoma

Telman¹,

Kouperberg²,

Cohen³

et al. 2010

Neurol Int

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This is the first reported attempt to examine the emboliogenic potential of cardiac myxoma in patients with acute stroke through the monitoring of microembolic signals (MES) by transcranial doppler. A 43-year old woman was brought to the emergency department because of acute onset of generalized tonic-clonic seizures and left hemiplegia. A CT scan of the brain demonstrated a large acute infraction in the territory of the right middle cerebral artery (MCA) and another smaller one in the territory of the posterior cerebral artery on the same side. Trans-cranial doppler (TCD) microemboli monitoring did not reveal MES. Transesophagial echocardiography (TEE) identified a 5 cm left atrial mass, which was highly suspected to be an atrial myxoma attached to the interatrial septum and prolapsed through the mitral valve. After the TEE results were obtained, another TCD monitoring was performed. Again, there were no MES found in either of the MCAs.Our findings showed the absence of MES on two consecutive TCD examinations, suggesting a spontaneous occurrence, rather than the permanent presence, of embolization, even in the most acute phase of stroke. Thus, the tendency of myxomas to spontaneously produce multiple emboli emphasizes the need for the surgical excision of myxomas.

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Section: Discussionsupporting

confidence: 78%

Microemboli monitoring by trans-cranial doppler in patient with acute cardioemboliogenic stroke due to atrial myxoma

Telman¹,

Kouperberg²,

Cohen³

et al. 2010

Neurol Int

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“…These cardiovascular symptoms come from mitral valve obstruction and/or elevated left atrial pressure and include chest pain, dyspnea on exertion, orthopnea, and paroxysmal nocturnal dyspnea. 11 , 25 - 27 Other significant manifestations are neurological deficits from embolization of the myxoma, leading to events related to cerebral ischemia or infarction, 27 , 28 retinal artery occlusion, 29 and even sudden death. 21 However, patients can also present asymptomatically or with minimal cardiac symptoms.…”

Section: Discussionmentioning

confidence: 99%

Giant Left Atrial Myxoma Masquerading as Cough-Syncope Syndrome

Bowman

Treece

Bhattad

et al. 2017

Journal of Investigative Medicine High Impact Case Reports

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Left atrial myxomas are the most common type of benign primary cardiac tumor. Patients can present with generalized symptoms, such as fatigue, symptoms from obstruction of the myxoma, or even embolization of the myxoma causing distal thrombosis. We describe a case with several-month duration of syncopal episodes that occurred after coughing and with exertion. Computed tomography of the chest showed a 6.1 cm by 4.5 cm mass in the left atrium, later evaluated with an echocardiogram. Cardiothoracic surgery removed the mass, and it was determined to be an atrial myxoma. It is important for an internist to be able to diagnose an atrial myxoma because of the risks associated with embolization and even sudden death as myxoma can block blood supply from atrium to ventricle.

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“…Atrial myxomas are rare and an uncommon cause of stroke [1][2][3]. Although rare in nature, complications from untreated atrial myxoma may result in catastrophic events, including recurrent systemic embolism and obstructive valve disease [1].…”

Section: Introductionmentioning

confidence: 99%

Silent cardiac tumor with neurological manifestations

Gil

Marmelo

Abreu

et al. 2017

Journal of Cardiology Cases

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Atrial myxoma is rare and can be completely asymptomatic. However, an untreated myxoma may result in catastrophic events. Diagnosis is usually suggested by echocardiography, and other imaging modalities can add important information. Myxoma can be cured surgically, and histological analysis usually gives the definite diagnosis. This article describes the case of a 61-year-old woman whose clinical presentation of an atrial myxoma was a stroke. Echocardiographic findings were highly suggestive of a cardiac myxoma. However, cardiac magnetic resonance showed unusual features for myxoma, since the mass was hyperintense in T1-weighted images and hypointense in T2-weighted sequences. Histology confirmed myxoma and the patient was surgically treated. This case enhances the importance of multimodality imaging in the differential diagnosis of cardiac masses.

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Cerebral ischemia as initial neurological manifestation of atrial myxoma: case report

Cited by 7 publications

References 16 publications

Microemboli monitoring by trans-cranial doppler in patient with acute cardioemboliogenic stroke due to atrial myxoma

Microemboli monitoring by trans-cranial doppler in patient with acute cardioemboliogenic stroke due to atrial myxoma

Giant Left Atrial Myxoma Masquerading as Cough-Syncope Syndrome

Silent cardiac tumor with neurological manifestations

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