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Published on: September 17, 2015
Brainstem stroke caused by left atrial cardiac papillary fibroelastoma: an increasingly recognized rare cause of
Luke Bonavia1, Justin Jackson1, Jennifer Pui-Yee Law1
1Albury Base Hospital NSW, Epworth Eastern Hospital and Melbourne Pathology Victoria, Australia.
Insights
Cardiac papillary fibroelastoma, a rare cause of embolic stroke, can affect older adults. Prompt echocardiographic imaging is crucial for diagnosing this condition and guiding timely surgical management.
Area of Science:
- Cardiology
- Neurology
- Oncology
Background:
- Cardiac papillary fibroelastoma (CPF) is a rare cardiac tumor.
- CPFs are an increasingly recognized cause of embolic stroke, particularly in elderly patients.
- Prompt surgical intervention is often necessary for managing CPFs.
Observation:
- A 76-year-old gentleman presented with left internuclear ophthalmoplegia and ataxia.
- Brain magnetic resonance imaging revealed diffusion-weighted imaging abnormalities consistent with stroke.
- The patient was diagnosed with a left atrial appendage cardiac fibroelastoma.
Findings:
- This case highlights an unusual presentation of CPF.
- The findings underscore the significance of echocardiography in evaluating cardioembolic stroke in older adults.
- Early detection through echocardiography is critical for effective treatment.
Implications:
- This case emphasizes the need for considering rare cardiac tumors in the differential diagnosis of stroke in the elderly.
- Echocardiographic screening can aid in the early identification of cardiac sources of embolism.
- Timely diagnosis and surgical management of CPF can prevent further embolic events and improve patient outcomes.
Abstract:
Cardiac papillary fibroelastoma is a rare but increasingly recognized cause of embolic stroke that is prevalent in the older population and requires prompt surgical management. We report an unusual case of left atrial appendage cardiac fibroelastoma in a 76-year-old gentleman who presented with left internuclear ophthalmoplegia and ataxia, with corresponding diffusion-weighted imaging on magnetic resonance imaging of the brain. This case illustrates the importance of echocardiographic imaging in the workup of cardioembolic stroke in the older adult population in the acute setting.
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