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Myxoma is a cardiac tumor most commonly found in the left atrium, presenting most frequently with dyspnea, chest pain, and constitutional symptoms. Hereby, we are presenting a rare case of cardiac myxoma originating from the left ventricle, presenting with an ischemic stroke in a young individual. He underwent surgical excision of the mass.

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A 35-year-old man presented to the emergency department with reports of chest pain, progressive shortness of breath, and pedal edema. He had a history of multiple hospital admissions without improvement. Multimodality imaging revealed a suspected giant right atrial myxoma.

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Cardioembolic stroke caused by atrial myxoma.

BMJ Case Rep

January 2025

ARHC/Stroke Service, Naas General Hospital, Naas, Kildare, Ireland.

A woman in her early 60s presented with multiple transient neurological symptoms over the course of 20 months, including transient loss of power to her right lower limb. Initial workup with CT brain scan, carotid dopplers and ECG revealed no abnormality; however, MRI of the brain suggested recent ischaemic events in separate cortical territories. Subsequent transoesophageal echocardiogram revealed a large mobile mass histologically confirmed to be an atrial myxoma.

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Background: The differential diagnosis of cardiac myxomas (CM), the most common benign primary cardiac tumors, is broad and a thorough diagnostic workup is required to establish accurate diagnosis prior to surgical resection. Transthoracic echocardiography (TTE) is usually the first imaging modality used for diagnosis of suspected CM. In a single tertiary centre study, we sought to determine the accuracy, sensitivity, and specificity of TTE in the diagnosis of CM and to determine echocardiographic characteristics indicative of CM.

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Cardiac myxomas are benign tumors of the heart. They occur mostly in the left atrium. The preferred treatment is surgical resection, which can be performed via conventional median sternotomy, minimally invasive, or robotic-assisted approaches.

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