Papillary Fibroelastoma as a Cause of Cardiogenic Embolic Stroke in a β-Thalassemia Patient: Case Report and Literature Review
We describe a case of a young male without stroke risk factors who presented with a sudden onset of left-sided weakness, left hand numbness, and left eye blurriness. CT scan of the head without contrast and diffusion-weighted MRI of the brain with contrast revealed an ischemic stroke in the right mi...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2017/8185601 |
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| author | Re-I Chin John J. Monda Maulik Sheth William Ogle Gloria Merenda Debapriya De |
| author_facet | Re-I Chin John J. Monda Maulik Sheth William Ogle Gloria Merenda Debapriya De |
| author_sort | Re-I Chin |
| collection | DOAJ |
| description | We describe a case of a young male without stroke risk factors who presented with a sudden onset of left-sided weakness, left hand numbness, and left eye blurriness. CT scan of the head without contrast and diffusion-weighted MRI of the brain with contrast revealed an ischemic stroke in the right middle cerebral artery distribution. Transesophageal echocardiography (TEE) revealed a mobile pedunculated mass on the posterior surface of the mitral valve. This mass was resected and pathology showed a cardiac papillary fibroelastoma (CPFE), which was determined to be the cause of the patient’s cardioembolic stroke. Further workup also found that patient had microcytic anemia secondary to β-thalassemia intermedia, a rare hematologic disorder due to defective hemoglobin synthesis. Recently, another case report suggested β-thalassemia major may underlie the pathogenesis of CPFE. β-Thalassemia major causes a state of chronic inflammation and endothelial damage, which can mediate CPFE formation. Based on literature review, this is the first case report of a CPFE in a patient with β-thalassemia intermedia. This hypothesis-generating case report calls attention to the need for elucidating the relationship between CPFE and β-thalassemia in future studies to better understand the diagnosis and management of a rare cardiac tumor. |
| format | Article |
| id | doaj-art-3a00a6eda69841e3aa8fd35581b412e3 |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-3a00a6eda69841e3aa8fd35581b412e32025-08-20T03:55:40ZengWileyCase Reports in Cardiology2090-64042090-64122017-01-01201710.1155/2017/81856018185601Papillary Fibroelastoma as a Cause of Cardiogenic Embolic Stroke in a β-Thalassemia Patient: Case Report and Literature ReviewRe-I Chin0John J. Monda1Maulik Sheth2William Ogle3Gloria Merenda4Debapriya De5Saint Louis University School of Medicine, 1402 S Grand Blvd, Saint Louis, MO 63104, USASaint Louis University School of Medicine, 1402 S Grand Blvd, Saint Louis, MO 63104, USADepartment of Internal Medicine, SSM St. Mary’s Health Center, 6420 Clayton Rd, Richmond Heights, MO 63117, USADepartment of Cardiothoracic Surgery, SSM St. Mary’s Health Center, 6420 Clayton Rd, Richmond Heights, MO 63117, USADepartment of Pathology, SSM St. Mary’s Health Center, 6420 Clayton Rd, Richmond Heights, MO 63117, USADepartment of Internal Medicine, SSM St. Mary’s Health Center, 6420 Clayton Rd, Richmond Heights, MO 63117, USAWe describe a case of a young male without stroke risk factors who presented with a sudden onset of left-sided weakness, left hand numbness, and left eye blurriness. CT scan of the head without contrast and diffusion-weighted MRI of the brain with contrast revealed an ischemic stroke in the right middle cerebral artery distribution. Transesophageal echocardiography (TEE) revealed a mobile pedunculated mass on the posterior surface of the mitral valve. This mass was resected and pathology showed a cardiac papillary fibroelastoma (CPFE), which was determined to be the cause of the patient’s cardioembolic stroke. Further workup also found that patient had microcytic anemia secondary to β-thalassemia intermedia, a rare hematologic disorder due to defective hemoglobin synthesis. Recently, another case report suggested β-thalassemia major may underlie the pathogenesis of CPFE. β-Thalassemia major causes a state of chronic inflammation and endothelial damage, which can mediate CPFE formation. Based on literature review, this is the first case report of a CPFE in a patient with β-thalassemia intermedia. This hypothesis-generating case report calls attention to the need for elucidating the relationship between CPFE and β-thalassemia in future studies to better understand the diagnosis and management of a rare cardiac tumor.http://dx.doi.org/10.1155/2017/8185601 |
| spellingShingle | Re-I Chin John J. Monda Maulik Sheth William Ogle Gloria Merenda Debapriya De Papillary Fibroelastoma as a Cause of Cardiogenic Embolic Stroke in a β-Thalassemia Patient: Case Report and Literature Review Case Reports in Cardiology |
| title | Papillary Fibroelastoma as a Cause of Cardiogenic Embolic Stroke in a β-Thalassemia Patient: Case Report and Literature Review |
| title_full | Papillary Fibroelastoma as a Cause of Cardiogenic Embolic Stroke in a β-Thalassemia Patient: Case Report and Literature Review |
| title_fullStr | Papillary Fibroelastoma as a Cause of Cardiogenic Embolic Stroke in a β-Thalassemia Patient: Case Report and Literature Review |
| title_full_unstemmed | Papillary Fibroelastoma as a Cause of Cardiogenic Embolic Stroke in a β-Thalassemia Patient: Case Report and Literature Review |
| title_short | Papillary Fibroelastoma as a Cause of Cardiogenic Embolic Stroke in a β-Thalassemia Patient: Case Report and Literature Review |
| title_sort | papillary fibroelastoma as a cause of cardiogenic embolic stroke in a β thalassemia patient case report and literature review |
| url | http://dx.doi.org/10.1155/2017/8185601 |
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