Cardiac papillary fibroelastoma is a rare cause of ischemic stroke in young adults that requires surgical excision to prevent recurrent complications.
May support excision of asymptomatic papillary fibroelastoma to avert stroke; leaves open need for prospective outcome data.
Among etiologies of stroke in young adults, primary cardiac tumors are very rare. We report the case of a 37-year-old woman who was admitted for an ischemic stroke in the right middle cerebral artery region. Etiologic investigations revealed, after transthoracic and transesophageal echocardiography, an aortic valve tumor. Treatment was first medical with anticoagulation, then surgical. Histological examination showed a papillary fibroelastoma. After a review of the literature, the possible mechanisms of the ischemic event are discussed and lead to the conclusion that this tumor must be surgically excised, even if asymptomatic, because of recurrent ischemic complications responsible for myocardial infarction, stroke and sudden death.
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Giannesini et al. (1999) studied this question.
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