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- Title
Paroxysmal atrial fibrillation, syncope and previous stroke: a frequent association, but not always a classic etiology!
- Authors
Matei, Claudia; Kozma, Gabriela; Bindea, Dan; Pop, Calin
- Abstract
Introduction-Atrial fibrillation (AF) accounts for over 50% of strokes, also known as cerebrovascular accidents (CVAs). We report a case of a right atrial (RA) myxoma presenting as paroxysmal AF, syncope and acute chest pain, in a patient with previous CVA. Description of the problem. A 62-year-old Caucasian woman was admitted for an episode of syncope and acute chest pain. Two years earlier she had suffered a CVA. Paroxysmal AF was noted at that time. At current presentation pulmonary thromboembolism (PE) was ruled out by pulmonary CT. TTE combined with TOE showed a large moving mass in the RA, prolapsing through the tricuspid valve into the right ventricle. The coronary arteries were normal. The patient underwent surgical treatment. The histopathological study confi rmed diagnosis of myxoma. Questions, problems. Up to 25% of myxomas are found in RA. Chest pain is infrequent. Syncope is experienced by approximately 20% of patients. Our patient had confi rmed TTE obstruction of the tricuspid valve and PE was ruled out by CT pulmonary scan. Conclusions-TTE must be considered at admission to clarify etiology in all AF and stroke patients. Although TOE is more sensitive, TTE is usually adequate for the diagnosis of cardiac myxomas.
- Publication
Romanian Journal of Cardiology, 2017, Vol 27, Issue 3, p391
- ISSN
1220-658X
- Publication type
Case Study