Key result
Surgical removal of a cardiac myxoma in a patient presenting with cerebral emboli and central retinal artery occlusion led to near-complete resolution of hemiparesis, though vision loss remained.
Case Report (n=1)
Cardiac myxomas can present without constitutional symptoms and may only be detected after severe embolic events like stroke and central retinal artery occlusion.
Cardiac myxomas are benign tumors of endocardial origin that usually occur in the left atrium. Trans-thoracic echocardiography is the diagnostic method of choice, and early surgical removal is the preferred method of treatment. We present a patient whose history of cerebral emboli and central retinal artery occlusion (CRAO) led to a diagnosis of cardiac myxoma. Neuroimaging studies showed multiple infarcts in the region of the left middle and anterior cerebral arteries. Ophthalmic examination showed gross retinal pallor compatible with left central retinal artery occlusion (CRAO). The etiology of stroke was investigated by performing trans-thoracic echocardiography, which showed a mass in the left atrium compatible with cardiac myxoma. Complete removal of the cardiac tumor was performed by open-heart surgery. Fortunately, after a period of rehabilitation, the patient's hemiparesis almost completely resolved, but the loss of vision OS remained unchanged. Many cases of myxoma are accompanied by constitutional symptoms, such as anemia, fever and weight loss, which allow for a diagnosis to made before serious complications such as embolism occur. Unfortunately, in some patients, such as ours, the absence of signs and symptoms allows the myxoma to pass completely unnoticed until the first embolic event occurs.
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Gálvez‐Ruiz et al. (2017) conducted a case report in Cardiac myxoma with cerebral emboli and central retinal artery occlusion (n=1). Open-heart surgery for tumor removal was evaluated on Resolution of symptoms (hemiparesis and vision loss). Surgical removal of a cardiac myxoma in a patient presenting with cerebral emboli and central retinal artery occlusion led to near-complete resolution of hemiparesis, though vision loss remained.
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