Cargando…
An atypical cause of myocardial infarction: case report of an obstructing papillary fibroelastoma of the aortic valve
BACKGROUND: Papillary fibroelastomas are rare primary cardiac tumours with a prevalence of 0.01% at autopsy. They are histologically benign tumours but have been demonstrated through case series to confer an increased risk of thrombo-embolism resulting in: transient ischaemic attack, stroke, myocard...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6601164/ https://www.ncbi.nlm.nih.gov/pubmed/31449619 http://dx.doi.org/10.1093/ehjcr/ytz058 |
_version_ | 1783431251615547392 |
---|---|
author | Logan, Niamh Islam, Mohammad Sirajul Chughtai, Jehan Zeb Murphy, Niamh F |
author_facet | Logan, Niamh Islam, Mohammad Sirajul Chughtai, Jehan Zeb Murphy, Niamh F |
author_sort | Logan, Niamh |
collection | PubMed |
description | BACKGROUND: Papillary fibroelastomas are rare primary cardiac tumours with a prevalence of 0.01% at autopsy. They are histologically benign tumours but have been demonstrated through case series to confer an increased risk of thrombo-embolism resulting in: transient ischaemic attack, stroke, myocardial infarction, and pulmonary and systemic embolization. CASE SUMMARY: A 54-year-old woman presented with central chest pain radiating to her left arm. At presentation there was a significant troponin rise; initial high-sensitivity troponin-I (hsTn-I) 660 pg/mL increased to 3340 pg/mL at 6 h. Coronary angiogram did not reveal any obstructing coronary artery disease. Echocardiography revealed a rounded, mobile mass on the left coronary cusp of the aortic valve suspicious for papillary fibroelastoma. The patient underwent shave excision of the lesion. Intra-operatively it was noted that the mass intermittently sat within the ostium of the left main resulting in its occlusion. Histology confirmed a papillary fibroelastoma. DISCUSSION: Primary cardiac tumours are rare but can cause life-threatening complications such as stroke, myocardial infarction, and cardiac arrest. In the literature, the mechanism of these complications is mainly attributed to thrombo-embolism. This case demonstrates the utility of echocardiogram in investigating and diagnosing a rare cause of myocardial infarction and highlights an unusual mechanism, that is tumour causing obstruction of the coronary ostium. |
format | Online Article Text |
id | pubmed-6601164 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-66011642019-07-29 An atypical cause of myocardial infarction: case report of an obstructing papillary fibroelastoma of the aortic valve Logan, Niamh Islam, Mohammad Sirajul Chughtai, Jehan Zeb Murphy, Niamh F Eur Heart J Case Rep Case Reports BACKGROUND: Papillary fibroelastomas are rare primary cardiac tumours with a prevalence of 0.01% at autopsy. They are histologically benign tumours but have been demonstrated through case series to confer an increased risk of thrombo-embolism resulting in: transient ischaemic attack, stroke, myocardial infarction, and pulmonary and systemic embolization. CASE SUMMARY: A 54-year-old woman presented with central chest pain radiating to her left arm. At presentation there was a significant troponin rise; initial high-sensitivity troponin-I (hsTn-I) 660 pg/mL increased to 3340 pg/mL at 6 h. Coronary angiogram did not reveal any obstructing coronary artery disease. Echocardiography revealed a rounded, mobile mass on the left coronary cusp of the aortic valve suspicious for papillary fibroelastoma. The patient underwent shave excision of the lesion. Intra-operatively it was noted that the mass intermittently sat within the ostium of the left main resulting in its occlusion. Histology confirmed a papillary fibroelastoma. DISCUSSION: Primary cardiac tumours are rare but can cause life-threatening complications such as stroke, myocardial infarction, and cardiac arrest. In the literature, the mechanism of these complications is mainly attributed to thrombo-embolism. This case demonstrates the utility of echocardiogram in investigating and diagnosing a rare cause of myocardial infarction and highlights an unusual mechanism, that is tumour causing obstruction of the coronary ostium. Oxford University Press 2019-05-05 /pmc/articles/PMC6601164/ /pubmed/31449619 http://dx.doi.org/10.1093/ehjcr/ytz058 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Case Reports Logan, Niamh Islam, Mohammad Sirajul Chughtai, Jehan Zeb Murphy, Niamh F An atypical cause of myocardial infarction: case report of an obstructing papillary fibroelastoma of the aortic valve |
title | An atypical cause of myocardial infarction: case report of an obstructing papillary fibroelastoma of the aortic valve |
title_full | An atypical cause of myocardial infarction: case report of an obstructing papillary fibroelastoma of the aortic valve |
title_fullStr | An atypical cause of myocardial infarction: case report of an obstructing papillary fibroelastoma of the aortic valve |
title_full_unstemmed | An atypical cause of myocardial infarction: case report of an obstructing papillary fibroelastoma of the aortic valve |
title_short | An atypical cause of myocardial infarction: case report of an obstructing papillary fibroelastoma of the aortic valve |
title_sort | atypical cause of myocardial infarction: case report of an obstructing papillary fibroelastoma of the aortic valve |
topic | Case Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6601164/ https://www.ncbi.nlm.nih.gov/pubmed/31449619 http://dx.doi.org/10.1093/ehjcr/ytz058 |
work_keys_str_mv | AT loganniamh anatypicalcauseofmyocardialinfarctioncasereportofanobstructingpapillaryfibroelastomaoftheaorticvalve AT islammohammadsirajul anatypicalcauseofmyocardialinfarctioncasereportofanobstructingpapillaryfibroelastomaoftheaorticvalve AT chughtaijehanzeb anatypicalcauseofmyocardialinfarctioncasereportofanobstructingpapillaryfibroelastomaoftheaorticvalve AT murphyniamhf anatypicalcauseofmyocardialinfarctioncasereportofanobstructingpapillaryfibroelastomaoftheaorticvalve AT loganniamh atypicalcauseofmyocardialinfarctioncasereportofanobstructingpapillaryfibroelastomaoftheaorticvalve AT islammohammadsirajul atypicalcauseofmyocardialinfarctioncasereportofanobstructingpapillaryfibroelastomaoftheaorticvalve AT chughtaijehanzeb atypicalcauseofmyocardialinfarctioncasereportofanobstructingpapillaryfibroelastomaoftheaorticvalve AT murphyniamhf atypicalcauseofmyocardialinfarctioncasereportofanobstructingpapillaryfibroelastomaoftheaorticvalve |