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A 34-year-old man with sudden palpitations, dyspnea, and chest pain was found to have tachycardia and unilateral pulmonary congestion. Intravenous adenosine restored sinus rhythm. Imaging and pathology confirmed an atrial myxoma with severe mitral regurgitation, requiring surgical excision and mitral valve replacement.

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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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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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Rationale: Thrombus is the most common occupying lesion in the cardiac chambers, it is often distinguished from cardiac neoplastic occupations. Among them, the most common is cardiac myxoma, whose imaging manifestations are often confused with thrombus. However, the 2 types of lesions have different therapeutic strategies and are both potentially high-risk sources of embolism, so early differentiation between intracardiac thrombus and cardiac tumor is essential.

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