Stroke due to a cardiac myxoma

Abstract

Cardioembolic stroke is an important cause of stroke in young people. Cardioembolism classically causes infarcts in multiple vascular territories. In the case described here a young woman developed cardioembolic stroke secondary to atrial myxoma. The presentation was atypical in that the woman had no systemic manifestations of her myxoma.

Figure 1. Magnetic resonance imaging of the brain, revealing: a vermian infarct on (A) FLAIR (B) T₂-weighted, and (C) diffusion-weighted imaging;

a right occipital infarct on (D) FLAIR and (E) diffusion-weighted imaging; and a left frontal infarct on (F) FLAIR imaging with (G) haemosiderin evident on gradient echo.

Figure 2. Parasternal view of the transthoracic echocardiogram demonstrating a left atrial myxoma (solid arrow), measuring 4.6×2.3 cm, protruding through the mitral valve, with its stalk attached just behind the anterior leaflet of the mitral valve and below the aortic valve (dashed arrow).

Figure 3. Macroscopic view of the left atrial myxoma.