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      A Rare Case of Aortic Valve Myxoma: An Unusual Cause of Embolic Stroke

      case-report

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          Abstract

          Aortic valve myxoma is an extremely rare cardiac tumour. We describe a 60-year-old woman found to have an aortic valve myxoma and a patent foramen ovale (PFO) presenting as a stroke. In view of the recurrent cerebral ischaemic events, the aortic valve myxoma was surgically removed and the PFO was closed. To the best of our knowledge, this is the first reported case of aortic valve myxoma with a PFO. We also highlight the importance of identifying a possible cardiac source of embolism in a stroke patient and considering this rare tumour as a cause in patients with a cryptogenic stroke.

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          Primary cardiac valve tumors.

          Bruce Hale, Fabiano Thompson, A Thomas Pezzella … (1991)
          To investigate the characteristics of primary cardiac valve tumors, we retrospectively analyzed our multiinstitutional experience from 1932 through 1990. We encountered 56 valvular tumors in 53 patients. The average age of these patients was 52 years (range, 2 to 88 years) and 79% (42/53) were male. Symptoms were present in 38% (20/53) and were neurological in 15% (8/53). Four patients experienced sudden death. Each of the four valves was affected with approximately equal frequency: 16 aortic, 15 mitral, 13 pulmonary, and 12 tricuspid. All but four tumors were benign. The most common histological type was papillary fibroelastoma (41), followed by myxomas (5), fibromas (4), sarcomas (2), hamartoma (1), hemangioma (1), histiocytoma (1), and undifferentiated (1). Average tumor size was 1.15 cm (range, 3 mm to 7 cm), and the average size of fibroelastomas was 8 mm (range, 3 to 15 mm). Mitral valve tumors were more likely than aortic valve tumors to produce serious neurological symptoms or sudden death (8/15 versus 3/16; p less than 0.05). Six patients underwent echocardiography, and results were positive in each. All 6 underwent uncomplicated valve repair or replacement. Compared with a series of 407 nonvalvular tumors, cardiac valve tumors are more likely to occur in male patients (p less than 0.001) and adults (p less than 0.001). Valve tumors are also more commonly benign (p less than 0.001) and asymptomatic (p less than 0.001). These tumors demonstrate somewhat less aggressive behavior compared with non-valvular tumors, but their distinct propensity to produce serious clinical sequelae argues in favor of surgical resection for all cardiac valve tumors.
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            Cardioembolic stroke: an update

            José M. Ferro (2003)
            Article 0 comments Cited 35 times – based on 0 reviews     Review now
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              Stroke subtype and mortalitya follow-up study in 998 patients with a first cerebral infarct

              G DeJong, L VANRAAK, F Kessels … (2003)
              Article 0 comments Cited 21 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (publisher-id): CRD
                Journal ID (nlm-ta): Cardiology
                Journal ID (doi): 10.1159/issn.0008-6312
                Title: Cardiology
                Publisher: S. Karger AG
                ISSN (Print): 0008-6312
                ISSN (Electronic): 1421-9751
                Publication date Subscription-year: 2011
                Publication date (Print): June 2011
                Publication date (Electronic): 04 May 2011
                Volume: 118
                Issue: 2
                Pages: 101-103
                Affiliations
                aUniversity Hospital Aintree, bLiverpool Heart and Chest Hospital, Liverpool, and cWhiston Hospital, Prescot, UK
                Author notes
                *Dr. Shiva Prasad Koyalakonda, MRCP, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL (UK), Tel. +44 78 0946 4149, E-Mail koyalashiva@gmail.com
                Article
                Publisher ID: 327081 Other ID: Cardiology 2011;118:101–103
                DOI: 10.1159/000327081
                PubMed ID: 21540590
                SO-VID: 7fc5695b-2e08-4773-8831-91718e497aff
                Copyright © © 2011 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 01 March 2011
                Page count
                Figures: 2, Pages: 3
                Categories
                Subject: Novel Insights from Clinical Experience

                ScienceOpen disciplines: General medicine,Neurology,Cardiovascular Medicine,Internal medicine,Nephrology
                Keywords: Right coronary cusp,Aortic valve myxoma,Patent foramen ovale,Stroke
                Data availability:
                ScienceOpen disciplines: General medicine, Neurology, Cardiovascular Medicine, Internal medicine, Nephrology
                Keywords: Right coronary cusp, Aortic valve myxoma, Patent foramen ovale, Stroke

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