Best Cases: Cardiac Masses-An Unusual Cause for CVA Diagnosed by Cardiac Magnetic Resonance

An Unusual Cause for CVA Diagnosed by Cardiac Magnetic Resonance

Video Transcription

Video Summary

A 77-year-old man with coronary artery disease, ischemic cardiomyopathy, and antiphospholipid syndrome presented with gait instability and multiple acute brain infarcts. Echocardiography revealed a mobile left ventricular mass, initially considered thrombus, myxoma, or papillary muscle. Cardiac MRI showed a mobile mass attached to the anterolateral papillary muscle with long T1, low first-pass perfusion, and strong late gadolinium enhancement, suggesting a fibroma-like lesion. After surgical removal, pathology confirmed papillary fibroelastoma. The case highlights cardiac MRI’s value in characterizing cardiac masses and identifying embolic sources when echocardiography is inconclusive.

Keywords

papillary fibroelastoma

cardiac MRI

left ventricular mass

embolic stroke

echocardiography