Cardiac myxoma and its implications for cardioembolic stroke

Cardiac myxoma (CM) is the most common type of primary cardiac tumor and a major embolic source of cardioembolic stroke. Two potential causative mechanisms are associated with CM-related ischemic stroke (CM-IS): Embolism from detached tumor debris and metastatic infiltration. The risk factors for embolism from CM remain unclear and are widely debated in the literature. CM-IS often initially presents with central nervous system complications. Diagnosis requires a comprehensive assessment of clinical manifestations, imaging findings, and laboratory test results, with histopathological examination required for a definitive diagnosis. Surgical resection of myxoma is the most effective CM-IS treatment, although the optimal timing and approach remain controversial. This review consolidates the current knowledge on CM-IS, identifies critical risk factors for embolic complications, and discusses contemporary treatment strategies, emphasizing the need for individualized management protocols and further research to improve outcomes in affected patients.