Related Experiment Video
Updated: Sep 17, 2025

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
Published on: August 26, 2025
Mobile Papillary Fibroelastoma Leading to Severe Chest Pain via Left Main Occlusion
Ariana Y Ramirez1, Kevin M Kashuba-Shanahan2, Joseph A Cavallaro1
1Department of Cardiology, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA.
Background:
Papillary fibroelastomas (PFEs) are common cardiac tumors. They are usually asymptomatic and identified incidentally.
Case Summary:
A 63-year-old woman presented with angina. Myocardial perfusion imaging was positive for anterior ischemia. Cardiac computed tomographic angiography (CCTA) showed no coronary atherosclerosis and a PFE within the left coronary cusp causing left main coronary artery (LMCA) occlusion during systole and early diastole. Surgical removal of the PFE resulted in symptom resolution.
Discussion:
Though benign, PFEs can cause coronary obstruction, usually involving the right coronary ostium. The use of CCTA is important for the localization, characterization, and visualization of PFE mobility throughout the cardiac cycle. This is a rare case of angina caused by LMCA obstruction by a mobile PFE.
Related Concept Videos
Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Pericarditis II: Clinical Features and Diagnostic Tests
Angina III: Clinical Manifestations and Assessment
Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
Mitral Stenosis II: Clinical features and Diagnostic Tests

