Rare cause of cardioembolic stroke and central retinal artery occlusion. 2021

Muhamad Izzad Johari, and Mohd Noor Ismail, and Fadhilah Mohamad, and Mohd Aizuddin Yusof
General Medicine, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia.

Primary cardiac valve tumours are rare. This is a case report of a 32-year-old non-smoker man with a history of stroke 1 year prior and no other cardiovascular risk factors. The patient was admitted to our acute stroke ward for recurrent left hemiparesis, slurring of speech, facial asymmetry and central retinal artery occlusion. Initial laboratory investigations and ECG were normal. An urgent CT brain showed a large hypodense area at the right frontal, parietal, temporal, occipital region with effaced sulci and right lateral ventricle with midline shift and cerebral oedema in keeping with acute infarction. We proceeded with CT angiography of the cerebral and carotid on the following day, which revealed no evidence of thrombosis, aneurysm or arteriovenous malformation. There were no abnormal beaded vessels to suggest vasculitis. Transthoracic echocardiography revealed a large mobile mass in the left atrium. Meanwhile, MRI cardiac confirmed a large ill-defined mobile solid mass attached to the mitral valve's inferoseptal component suggestive of mitral valve myxoma. This case report highlights the significance of considering a cardiogenic source of emboli in patients with large cerebral infarcts and other cardiac embolic phenomena. Imaging modalities such as echocardiography and cardiac MRI will help detect treatable conditions, such as valvular myxoma and prevent further complications.

UI MeSH Term Description Entries
D008297 Male Males
D008943 Mitral Valve The valve between the left atrium and left ventricle of the heart. Bicuspid Valve,Bicuspid Valves,Mitral Valves,Valve, Bicuspid,Valve, Mitral,Valves, Bicuspid,Valves, Mitral
D009232 Myxoma A benign neoplasm derived from connective tissue, consisting chiefly of polyhedral and stellate cells that are loosely embedded in a soft mucoid matrix, thereby resembling primitive mesenchymal tissue. It occurs frequently intramuscularly where it may be mistaken for a sarcoma. It appears also in the jaws and the skin. (From Stedman, 25th ed) Angiomyxoma,Angiomyxomas,Myxomas
D004452 Echocardiography Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. Echocardiography, Contrast,Echocardiography, Cross-Sectional,Echocardiography, M-Mode,Echocardiography, Transthoracic,Echocardiography, Two-Dimensional,Transthoracic Echocardiography,2-D Echocardiography,2D Echocardiography,Contrast Echocardiography,Cross-Sectional Echocardiography,Echocardiography, 2-D,Echocardiography, 2D,M-Mode Echocardiography,Two-Dimensional Echocardiography,2 D Echocardiography,Cross Sectional Echocardiography,Echocardiography, 2 D,Echocardiography, Cross Sectional,Echocardiography, M Mode,Echocardiography, Two Dimensional,M Mode Echocardiography,Two Dimensional Echocardiography
D006338 Heart Neoplasms Tumors in any part of the heart. They include primary cardiac tumors and metastatic tumors to the heart. Their interference with normal cardiac functions can cause a wide variety of symptoms including HEART FAILURE; CARDIAC ARRHYTHMIAS; or EMBOLISM. Cardiac Cancer,Cardiac Carcinoma,Cardiac Neoplasms,Cardiac Tumor,Cardiac Tumors,Heart Cancer,Heart Tumor,Intracavitary Tumors of the Heart,Myocardial Tumors (Rhabdomyomas and Fibromas),Neoplasms, Cardiac,Neoplasms, Heart,Primary Cardiac Tumors, Childhood,Cancer, Cardiac,Cancer, Heart,Cancers, Cardiac,Cancers, Heart,Carcinoma, Cardiac,Carcinomas, Cardiac,Cardiac Cancers,Cardiac Carcinomas,Cardiac Neoplasm,Heart Cancers,Heart Neoplasm,Heart Tumors,Myocardial Tumor (Rhabdomyomas and Fibromas),Neoplasm, Cardiac,Neoplasm, Heart,Tumor, Cardiac,Tumor, Heart,Tumor, Myocardial (Rhabdomyomas and Fibromas),Tumors, Cardiac,Tumors, Heart,Tumors, Myocardial (Rhabdomyomas and Fibromas)
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000083262 Embolic Stroke An ischemic stroke due to a blood clot, emboli or other types of blockage which forms somewhere other than the brain and subsequently travels near and restricts blood flow to the brain. Most often the origin of the clot is from the heart and is referred to as cardioembolic stroke. Cardio-embolic Stroke,Cardioembolic Stroke,Cardio embolic Stroke,Cardio-embolic Strokes,Cardioembolic Strokes,Embolic Strokes,Stroke, Cardio-embolic,Stroke, Cardioembolic,Stroke, Embolic,Strokes, Cardio-embolic,Strokes, Cardioembolic,Strokes, Embolic
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D014057 Tomography, X-Ray Computed Tomography using x-ray transmission and a computer algorithm to reconstruct the image. CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography
D015356 Retinal Artery Occlusion Sudden ISCHEMIA in the RETINA due to blocked blood flow through the CENTRAL RETINAL ARTERY or its branches leading to sudden complete or partial loss of vision, respectively, in the eye. Branch Retinal Artery Occlusion,Central Retinal Artery Occlusion,Occlusion, Retinal Artery,Occlusions, Retinal Artery,Retinal Artery Occlusions

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