Giant left atrial myxoma as a cause of recurrent cerebral emboli

Marcin Konopka, Witold Pikto-Pietkiewicz, Jacek Sawicki, Włodzimierz Gierlak, Mirosław Dłużniewski
A 78-year-old woman with mild left-side hemiplegia and aphasia was admitted to the neurological ward. It was her third stroke within 2 years. She had been treated for hypertension and diabetes for several years; she had no cardiac arrhythmia in history. Echocardiography performed 10 years earlier gave normal results. Computed tomography of the brain revealed a hypoattenuating ischemic lesion within the right anterior limb of the internal capsule and other small multiple ischemic lesions in
more » ... mic lesions in various vascular territories. Carotid and vertebral ultrasound did not show any significant stenosis. Holter monitoring performed during the previous and current hospitalization showed no arrhythmia. Despite that, in the period between the second and current episodes, the patient was taking rivaroxaban prescribed by a general practitioner owing to a suspicion of atrial fibrillation as a probable cause of recurrent stroke. The patient was referred for transthoracic echocardiography, which showed a large left atrial mobile tumor (40 × 24 mm) attached to FIGurE 1 Transthoracic echocardiography; A -parasternal long axis-view, systole; B -parasternal long-axis view, diastole; C -parasternal short-axis view; D -four-chamber view (three-dimensional echocardiography) Abbreviations: AoA -aortic arch, IVS -interventricular septum, LA -left atrium, LV -left ventricle, RA -right atrium, RV -right ventricle A C B D
pmid:23974291 fatcat:fpmd5a37pvghvjjxmk23fnj4ta