Is It Safe to Proceed with Thrombolytic Therapy for Acute Ischemic Stroke in a Patient with Cardiac Myxoma Case Report and Review of the Literature

mg/daily for stroke and deep venous thrombosis prevention. Later that day, the patient presented a worsening of her clinical status secondary to an embolic occlusion of her left femoral artery. Moreover, a transthoracic echocardiogram disclosed a 2 ! 2 cm mass inside the left atrium, raising suspicion of an atrial myxoma. She underwent urgent peripheral vascular and cardiac surgeries, which confirmed the finding of a left atrial myxoma. The blood pressure fluctuated throughout the lengthy surgery, with reported episodes of hypotension, and blood loss was estimated at approximately 1 liter. During the postoperative period, her neurological status deteriorated and an urgent computerized tomography scan was performed, showing diffuse parenchymal edema over the right MCA distribution, with associated midline shift. Urgent decompressive craniectomy was performed, but no clinical improvement was achieved. The patient evolved to brain death within the next 24 h.