Cardiac papillary fibroelastoma and cryptogenic stroke: a diagnostic and therapeutic challenge

Cardiac papillary fibroelastoma (CPF) is a rare, benign cardiac tumor with a significant risk for embolic complications, most notably ischemic stroke. This paper presents a case of a 54-year-old woman with cryptogenic stroke ultimately attributed to a CPF on the aortic valve, discovered via transeso...

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Main Authors: Sahil Sabharwal, Eunhae Hannah Bae, Dahae Hailey Bae, Pradeep Kumbham, Tyler Troutman, Sarah Assem
Format: Article
Language:English
Published: Open Exploration Publishing Inc. 2025-06-01
Series:Exploration of Cardiology
Subjects:
Online Access:https://www.explorationpub.com/uploads/Article/A101261/101261.pdf
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author Sahil Sabharwal
Eunhae Hannah Bae
Dahae Hailey Bae
Pradeep Kumbham
Tyler Troutman
Sarah Assem
author_facet Sahil Sabharwal
Eunhae Hannah Bae
Dahae Hailey Bae
Pradeep Kumbham
Tyler Troutman
Sarah Assem
author_sort Sahil Sabharwal
collection DOAJ
description Cardiac papillary fibroelastoma (CPF) is a rare, benign cardiac tumor with a significant risk for embolic complications, most notably ischemic stroke. This paper presents a case of a 54-year-old woman with cryptogenic stroke ultimately attributed to a CPF on the aortic valve, discovered via transesophageal echocardiography (TEE) after an initial unremarkable transthoracic study. Following diagnosis, the patient was treated with anticoagulation and scheduled for surgical excision. Although often asymptomatic, CPF can present with life-threatening embolic events, underscoring the importance of timely diagnosis through high-resolution imaging, particularly TEE. Surgical excision remains the definitive treatment in symptomatic or high-risk cases, but management of incidental, asymptomatic tumors remains controversial due to the absence of formal guidelines. This paper emphasizes the need for heightened clinical suspicion of CPF in cryptogenic stroke and advocates for individualized treatment approaches based on tumor characteristics and embolic risk.
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spelling doaj-art-a6a69207574f433abe62a7a50ed2ce4a2025-08-20T03:12:28ZengOpen Exploration Publishing Inc.Exploration of Cardiology2994-55262025-06-01310126110.37349/ec.2025.101261Cardiac papillary fibroelastoma and cryptogenic stroke: a diagnostic and therapeutic challengeSahil Sabharwal0https://orcid.org/0009-0008-4660-2169Eunhae Hannah Bae1https://orcid.org/0009-0005-0649-5205Dahae Hailey Bae2https://orcid.org/0009-0007-1690-8290Pradeep Kumbham3https://orcid.org/0009-0001-7351-8287Tyler Troutman4https://orcid.org/0009-0008-7990-2539Sarah Assem5https://orcid.org/0009-0007-1079-6232Internal Medicine, University of Arkansas for Medical Sciences, Northwest Regional Campus, Fayetteville, AR 72703, USAInternal Medicine, University of Arkansas for Medical Sciences, Northwest Regional Campus, Fayetteville, AR 72703, USAInternal Medicine, University of Arkansas for Medical Sciences, Northwest Regional Campus, Fayetteville, AR 72703, USANeurology, Mercy Hospital Northwest Arkansas, Rogers, AR 72758, USAInternal Medicine, Mercy Hospital Northwest Arkansas, Rogers, AR 72758, USAInternal Medicine, University of Arkansas for Medical Sciences, Northwest Regional Campus, Fayetteville, AR 72703, USACardiac papillary fibroelastoma (CPF) is a rare, benign cardiac tumor with a significant risk for embolic complications, most notably ischemic stroke. This paper presents a case of a 54-year-old woman with cryptogenic stroke ultimately attributed to a CPF on the aortic valve, discovered via transesophageal echocardiography (TEE) after an initial unremarkable transthoracic study. Following diagnosis, the patient was treated with anticoagulation and scheduled for surgical excision. Although often asymptomatic, CPF can present with life-threatening embolic events, underscoring the importance of timely diagnosis through high-resolution imaging, particularly TEE. Surgical excision remains the definitive treatment in symptomatic or high-risk cases, but management of incidental, asymptomatic tumors remains controversial due to the absence of formal guidelines. This paper emphasizes the need for heightened clinical suspicion of CPF in cryptogenic stroke and advocates for individualized treatment approaches based on tumor characteristics and embolic risk.https://www.explorationpub.com/uploads/Article/A101261/101261.pdfstrokepapillary fibroelastomaaortaechocardiographyembolism
spellingShingle Sahil Sabharwal
Eunhae Hannah Bae
Dahae Hailey Bae
Pradeep Kumbham
Tyler Troutman
Sarah Assem
Cardiac papillary fibroelastoma and cryptogenic stroke: a diagnostic and therapeutic challenge
Exploration of Cardiology
stroke
papillary fibroelastoma
aorta
echocardiography
embolism
title Cardiac papillary fibroelastoma and cryptogenic stroke: a diagnostic and therapeutic challenge
title_full Cardiac papillary fibroelastoma and cryptogenic stroke: a diagnostic and therapeutic challenge
title_fullStr Cardiac papillary fibroelastoma and cryptogenic stroke: a diagnostic and therapeutic challenge
title_full_unstemmed Cardiac papillary fibroelastoma and cryptogenic stroke: a diagnostic and therapeutic challenge
title_short Cardiac papillary fibroelastoma and cryptogenic stroke: a diagnostic and therapeutic challenge
title_sort cardiac papillary fibroelastoma and cryptogenic stroke a diagnostic and therapeutic challenge
topic stroke
papillary fibroelastoma
aorta
echocardiography
embolism
url https://www.explorationpub.com/uploads/Article/A101261/101261.pdf
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