In cases of nonfatal arterial emboli with normal cardiac evaluation, an aggressive search for a cardiac source like atrial myxoma is warranted to prevent fatal embolization.
May warrant targeted myxoma evaluation after nonfatal emboli despite normal morphology; leaves open need for prospective screening studies.
Right internal carotid and left brachial arterial occlusions resulting from left atrial myxoma occurred in the absence of cardiac findings to explain the embolization. Following surgical removal of the myxomatous emboli, a cardiac source was suspected, and therefore, cardiac surgery was performed. A small, irregular tumor base was found in the left atrium, but no morphologic heart abnormalities were present. When nonfatal arterial emboli occur, even in the presence of a normal cardiac evaluation, an aggressive angiographic and surgical search for the cause may prevent future fatal embolization due to primary cardiac myxoma. (JAMA228:864-865, 1974)
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Joseph Thompson (1974) studied this question.
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