What is the clinical evidence from this study?

Study design: Case Report. Population: Acute coronary syndrome secondary to aortic valve papillary fibroelastoma (n=1). Intervention: Surgical excision. Primary outcome: Survival and tumor recurrence.

What does this research mean for the field?

Aortic valve papillary fibroelastoma can cause acute coronary syndrome through transient obstruction of the left main coronary artery ostium. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To report a rare case of acute coronary syndrome caused by transient left main coronary artery ostial obstruction by an aortic valve papillary fibroelastoma and evaluate diagnostic imaging strategies.

September 17, 2026Journal of Medical Case ReportsOpen Access

Acute coronary syndrome secondary to aortic valve papillary fibroelastoma: a case report

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Key result

Surgical excision of aortic valve papillary fibroelastoma causing transient LMCA obstruction achieves 2-year recurrence-free survival.

Key Points

To report a rare case of acute coronary syndrome caused by transient left main coronary artery ostial obstruction by an aortic valve papillary fibroelastoma and evaluate diagnostic imaging strategies.
A 61-year-old North African female presenting with very-high-risk non-ST-elevation acute coronary syndrome and a history of unexplained ischemic stroke underwent multimodal diagnostic evaluation including TTE, TEE, cardiac CT, and cardiac MRI.
The patient was treated with surgical excision using median sternotomy with cardiopulmonary bypass, performing a native valve-sparing resection without valve replacement.
Diagnostic imaging identified a mobile 7 mm papillary fibroelastoma on the non-coronary aortic valve cusp causing dynamic, intermittent occlusion of the left main coronary artery ostium via a flap-effect mechanism.
Laboratory and electrocardiographic assessments demonstrated elevated troponin levels of 532 ng/L along with ST-segment elevation in lead aVR and diffuse ST depression.
Histopathological analysis confirmed the diagnosis of benign papillary fibroelastoma, and the patient experienced no ischemic or tumor recurrence at 2-year follow-up.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

A 61-year-old female with a history of diabetes, hypertension, sleep apnea, and ischemic stroke who presented with acute coronary syndrome secondary to an aortic valve papillary fibroelastoma and was followed for 2 years.

Intervention

Surgical excision of the aortic valve papillary fibroelastoma with preservation of the native valve.

Outcome

Survival and absence of tumor recurrence at follow-up.

Multimodality cardiac imaging is crucial for diagnosing rare causes of acute coronary syndrome, such as transient coronary ostial obstruction by a mobile aortic valve papillary fibroelastoma, which can be successfully managed with valve-sparing surgical excision.

Limitations

Single case report
Three-dimensional echocardiography was not available

Discussion

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Implication

Fibroelastoma may underlie high-risk NSTE-ACS; case report leaves open systematic valve imaging in embolic presentations.

Cite This Study

Thabet et al. (2026) conducted a case report in Acute coronary syndrome secondary to aortic valve papillary fibroelastoma (n=1). Surgical excision was evaluated on Survival and tumor recurrence. Surgical excision of an aortic valve papillary fibroelastoma causing transient left main coronary artery obstruction resulted in survival with no recurrence at 2-year follow-up.

synapsesocial.com/papers/6aabb7275f706d05830e5fd0 https://doi.org/10.1186/s13256-026-06470-5

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Acute coronary syndrome secondary to aortic valve papillary fibroelastoma: a case report

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Acute coronary syndrome secondary to aortic valve papillary fibroelastoma: a case report

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

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