Mitral valve papillary fibroelastoma as the cause of ischemic stroke in a young patient: A case report
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.12659/AJCR.930561 http://hdl.handle.net/11449/207445 |
Resumo: | Objective: Rare disease Background: Primary cardiac tumors represent less than 5% of total cardiac tumors. Fibroelastoma is a rare benign cardiac tumor that is usually asymptomatic but is acknowledged for its emboligenic potential for causing cardiac, neurological, and vascular symptoms and increasing patient morbidity and mortality. Case Report: This report describes the clinical case of a 27-year-old woman who entered the Emergency Department with motor aphasia and hemiparesis in the right dimidium. A brain computed tomography scan was performed at admission, which showed left frontal-parietal hypodensity. The diagnosis of ischemic stroke was made, but cerebral reperfusion therapy with intravenous recombinant tissue plasminogen activator was not instituted due to the time that had passed since ictus (15 h 40 min). On the first day of hospitalization, the patient had a fever, with no apparent infectious cause. She underwent transthoracic echocardiogram that showed a sessile, isoechoic mass adhered to the atrial surface of the anterior mitral valve leaflet, measuring 6.8×5.5 mm. Antibiotic therapy with ceftriaxone and gentamicin was initiated due to the initial diagnosis of infective endocarditis. Three blood culture samples had negative results. Given a differential diagnosis of fibroelastoma, transesophageal echocardiography and cardiac resonance imaging were performed, and the findings were compatible with a diagnosis of mitral valve fibroelastoma. After clinical discussion, the patient was referred to cardiac surgery and underwent tumor resection with anatomopathological diagnosis of papillary fibroelastoma of the heart valve. Conclusions: Young patients with ischemic stroke must be investigated with transthoracic and transesophageal echocardiograms. Papillary fibroelastoma is potential cause of ischemic stroke in young patients, and surgical resection is curative and has excellent prognosis. |
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Mitral valve papillary fibroelastoma as the cause of ischemic stroke in a young patient: A case reportEchocardiography, DopplerEndocardial FibroelastosisStrokeObjective: Rare disease Background: Primary cardiac tumors represent less than 5% of total cardiac tumors. Fibroelastoma is a rare benign cardiac tumor that is usually asymptomatic but is acknowledged for its emboligenic potential for causing cardiac, neurological, and vascular symptoms and increasing patient morbidity and mortality. Case Report: This report describes the clinical case of a 27-year-old woman who entered the Emergency Department with motor aphasia and hemiparesis in the right dimidium. A brain computed tomography scan was performed at admission, which showed left frontal-parietal hypodensity. The diagnosis of ischemic stroke was made, but cerebral reperfusion therapy with intravenous recombinant tissue plasminogen activator was not instituted due to the time that had passed since ictus (15 h 40 min). On the first day of hospitalization, the patient had a fever, with no apparent infectious cause. She underwent transthoracic echocardiogram that showed a sessile, isoechoic mass adhered to the atrial surface of the anterior mitral valve leaflet, measuring 6.8×5.5 mm. Antibiotic therapy with ceftriaxone and gentamicin was initiated due to the initial diagnosis of infective endocarditis. Three blood culture samples had negative results. Given a differential diagnosis of fibroelastoma, transesophageal echocardiography and cardiac resonance imaging were performed, and the findings were compatible with a diagnosis of mitral valve fibroelastoma. After clinical discussion, the patient was referred to cardiac surgery and underwent tumor resection with anatomopathological diagnosis of papillary fibroelastoma of the heart valve. Conclusions: Young patients with ischemic stroke must be investigated with transthoracic and transesophageal echocardiograms. Papillary fibroelastoma is potential cause of ischemic stroke in young patients, and surgical resection is curative and has excellent prognosis.Department of Cardiology Botucatu Medical School – UNESP São Paulo State UniversityDepartment of Cardiovascular Surgery Botucatu Medical School – UNESP São Paulo State UniversityDepartment of Pathology Botucatu Medical School – UNESP São Paulo State UniversityDepartment of Neurology Botucatu Medical School – UNESP São Paulo State UniversityDepartment of Cardiology Botucatu Medical School – UNESP São Paulo State UniversityDepartment of Cardiovascular Surgery Botucatu Medical School – UNESP São Paulo State UniversityDepartment of Pathology Botucatu Medical School – UNESP São Paulo State UniversityDepartment of Neurology Botucatu Medical School – UNESP São Paulo State UniversityUniversidade Estadual Paulista (Unesp)Vasconcelos, Milena Miranda [UNESP]Pupo da Silveira, Caroline F. da S.M. [UNESP]Felício, Marcello Laneza [UNESP]Moraes, Marcelo Padovani de Toledo [UNESP]Teixeira, Renato [UNESP]Trivellato, Stella de Angelis [UNESP]Modolo, Gabriel Pinheiro [UNESP]Bazan, Rodrigo [UNESP]Bazan, Silméia Garcia Zanati [UNESP]2021-06-25T10:55:14Z2021-06-25T10:55:14Z2021-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1-4http://dx.doi.org/10.12659/AJCR.930561American Journal of Case Reports, v. 22, n. 1, p. 1-4, 2021.1941-5923http://hdl.handle.net/11449/20744510.12659/AJCR.9305612-s2.0-85102454027Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengAmerican Journal of Case Reportsinfo:eu-repo/semantics/openAccess2021-10-23T17:16:42Zoai:repositorio.unesp.br:11449/207445Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462021-10-23T17:16:42Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Mitral valve papillary fibroelastoma as the cause of ischemic stroke in a young patient: A case report |
title |
Mitral valve papillary fibroelastoma as the cause of ischemic stroke in a young patient: A case report |
spellingShingle |
Mitral valve papillary fibroelastoma as the cause of ischemic stroke in a young patient: A case report Vasconcelos, Milena Miranda [UNESP] Echocardiography, Doppler Endocardial Fibroelastosis Stroke |
title_short |
Mitral valve papillary fibroelastoma as the cause of ischemic stroke in a young patient: A case report |
title_full |
Mitral valve papillary fibroelastoma as the cause of ischemic stroke in a young patient: A case report |
title_fullStr |
Mitral valve papillary fibroelastoma as the cause of ischemic stroke in a young patient: A case report |
title_full_unstemmed |
Mitral valve papillary fibroelastoma as the cause of ischemic stroke in a young patient: A case report |
title_sort |
Mitral valve papillary fibroelastoma as the cause of ischemic stroke in a young patient: A case report |
author |
Vasconcelos, Milena Miranda [UNESP] |
author_facet |
Vasconcelos, Milena Miranda [UNESP] Pupo da Silveira, Caroline F. da S.M. [UNESP] Felício, Marcello Laneza [UNESP] Moraes, Marcelo Padovani de Toledo [UNESP] Teixeira, Renato [UNESP] Trivellato, Stella de Angelis [UNESP] Modolo, Gabriel Pinheiro [UNESP] Bazan, Rodrigo [UNESP] Bazan, Silméia Garcia Zanati [UNESP] |
author_role |
author |
author2 |
Pupo da Silveira, Caroline F. da S.M. [UNESP] Felício, Marcello Laneza [UNESP] Moraes, Marcelo Padovani de Toledo [UNESP] Teixeira, Renato [UNESP] Trivellato, Stella de Angelis [UNESP] Modolo, Gabriel Pinheiro [UNESP] Bazan, Rodrigo [UNESP] Bazan, Silméia Garcia Zanati [UNESP] |
author2_role |
author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual Paulista (Unesp) |
dc.contributor.author.fl_str_mv |
Vasconcelos, Milena Miranda [UNESP] Pupo da Silveira, Caroline F. da S.M. [UNESP] Felício, Marcello Laneza [UNESP] Moraes, Marcelo Padovani de Toledo [UNESP] Teixeira, Renato [UNESP] Trivellato, Stella de Angelis [UNESP] Modolo, Gabriel Pinheiro [UNESP] Bazan, Rodrigo [UNESP] Bazan, Silméia Garcia Zanati [UNESP] |
dc.subject.por.fl_str_mv |
Echocardiography, Doppler Endocardial Fibroelastosis Stroke |
topic |
Echocardiography, Doppler Endocardial Fibroelastosis Stroke |
description |
Objective: Rare disease Background: Primary cardiac tumors represent less than 5% of total cardiac tumors. Fibroelastoma is a rare benign cardiac tumor that is usually asymptomatic but is acknowledged for its emboligenic potential for causing cardiac, neurological, and vascular symptoms and increasing patient morbidity and mortality. Case Report: This report describes the clinical case of a 27-year-old woman who entered the Emergency Department with motor aphasia and hemiparesis in the right dimidium. A brain computed tomography scan was performed at admission, which showed left frontal-parietal hypodensity. The diagnosis of ischemic stroke was made, but cerebral reperfusion therapy with intravenous recombinant tissue plasminogen activator was not instituted due to the time that had passed since ictus (15 h 40 min). On the first day of hospitalization, the patient had a fever, with no apparent infectious cause. She underwent transthoracic echocardiogram that showed a sessile, isoechoic mass adhered to the atrial surface of the anterior mitral valve leaflet, measuring 6.8×5.5 mm. Antibiotic therapy with ceftriaxone and gentamicin was initiated due to the initial diagnosis of infective endocarditis. Three blood culture samples had negative results. Given a differential diagnosis of fibroelastoma, transesophageal echocardiography and cardiac resonance imaging were performed, and the findings were compatible with a diagnosis of mitral valve fibroelastoma. After clinical discussion, the patient was referred to cardiac surgery and underwent tumor resection with anatomopathological diagnosis of papillary fibroelastoma of the heart valve. Conclusions: Young patients with ischemic stroke must be investigated with transthoracic and transesophageal echocardiograms. Papillary fibroelastoma is potential cause of ischemic stroke in young patients, and surgical resection is curative and has excellent prognosis. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-06-25T10:55:14Z 2021-06-25T10:55:14Z 2021-01-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.12659/AJCR.930561 American Journal of Case Reports, v. 22, n. 1, p. 1-4, 2021. 1941-5923 http://hdl.handle.net/11449/207445 10.12659/AJCR.930561 2-s2.0-85102454027 |
url |
http://dx.doi.org/10.12659/AJCR.930561 http://hdl.handle.net/11449/207445 |
identifier_str_mv |
American Journal of Case Reports, v. 22, n. 1, p. 1-4, 2021. 1941-5923 10.12659/AJCR.930561 2-s2.0-85102454027 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
American Journal of Case Reports |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
1-4 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
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UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
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1797790246350356480 |