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Related Concept Videos

Transient Ischemic Attack l: Introduction01:26

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A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Aneurysm I: Introduction01:30

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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
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Aortic valve fibroelastoma masquerading as transient ischaemic attack.

Penelope-Anne Gowland1, Ragheb Hasan1

  • 1Manchester Heart Centre, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK.

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A rare aortic valve papillary fibroelastoma caused chest pain and transient ischemic attacks (TIAs) in a 49-year-old man. Surgical removal of the tumor cured his symptoms and preserved his aortic valve.

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Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Surgical Oncology

Background:

  • Papillary fibroelastomas are rare, benign cardiac tumors often found on heart valves.
  • Despite their benign histology, these tumors pose significant risks of embolic events, leading to stroke or transient ischemic attacks (TIAs).
  • Aortic valve involvement can precipitate severe symptoms due to obstruction or embolization.

Purpose of the Study:

  • To report a case of a patient presenting with cardiac and neurological symptoms secondary to an aortic valve papillary fibroelastoma.
  • To highlight the diagnostic challenges and successful surgical management of this rare condition.
  • To emphasize the importance of timely intervention to prevent severe morbidity and mortality.

Main Methods:

  • A 49-year-old male presented with acute chest pain, shortness of breath, and left arm paresthesia.
  • Investigations revealed an aortic valve papillary fibroelastoma and a history of recurrent TIAs.
  • Urgent surgical excision of the tumor was performed, preserving the native aortic valve.

Main Results:

  • The patient experienced an uneventful recovery following the surgical removal of the papillary fibroelastoma.
  • Neurological symptoms, including TIAs, resolved completely post-operatively.
  • The aortic valve was successfully preserved, and the patient remained asymptomatic at follow-up.

Conclusions:

  • Aortic valve papillary fibroelastomas, though benign, necessitate prompt surgical intervention due to high embolic risk.
  • Surgical excision is an effective treatment, leading to symptom resolution and prevention of further complications.
  • Preservation of the native aortic valve is achievable in many cases, ensuring good long-term outcomes.