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Aortic valve papillary fibroelastoma causing embolic strokes: a case report and review

Authors Miller A, Perez A, Pabba S, Shetty V

Received 9 August 2016

Accepted for publication 13 October 2016

Published 29 March 2017 Volume 2017:10 Pages 109—112

DOI https://doi.org/10.2147/IMCRJ.S119353

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Professor Ronald Prineas


Avraham Miller,1 Audrik Perez,1 Swathi Pabba,2 Vijay Shetty3

1
Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA; 2Chalmeda Anand Rao Institute of Medical Sciences, Telangana, India; 3Department of Cardiology, Maimonides Medical Center, Brooklyn, NY, USA

Abstract: Papillary fibroelastomas (PFEs) are the second most common benign neoplasms of the cardiac valves and are being recognized more frequently because of higher resolution imaging technology. PFEs are associated with substantial complications that are secondary to systemic embolism. Surgical resection should be offered to all patients who have symptoms and to asymptomatic patients who have pedunculated lesions or tumors larger than 1 cm in diameter. Herein, we present a patient who presented for a second time in 2 months with stroke symptoms. During his first admission, a transthoracic echocardiogram was performed and he was sent home after resolution of his symptoms and a grossly negative workup. During his second admission, a transesophageal echocardiogram was performed and the PFE was found and later excised. While this discussion reviews the literature with regard to detection and management, it will hopefully serve as a reminder to keep this on the differential when the workup has remained without an obvious source.

Keywords: stroke, fibroelastoma, papillary, embolism

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