Cardiac papillary fibroelastoma: source of cerebral embolism treated with intravenous thrombolysis.
We present the case of a 41-year-old man with sudden development of left hemiparesis due to infarction of the right middle cerebral artery that was successfully treated with intravenous (IV) thrombolysis with alteplase. Transthoracic echocardiography showed a small mass in the left ventricle. The patient underwent surgical resection, and histological examination of the mass confirmed the diagnosis of papillary fibroelastoma. It remains to be investigated whether heart ultrasound evaluation should be performed before IV thrombolysis in selected patients with stroke, given the apparently increased risk of bleeding. However, IV thrombolysis should not be postponed due to a lengthy investigation, because of its potential for reducing morbidity in patients with stroke.
Matijević
Vesna
V
Department of Neurology, University Hospital Center, Zagreb, Croatia.
Poljaković
Zdravka
Z
Ilić
Ivana
I
Cikeš
Ivo
I
Habek
Mario
M
D000328:Adult; D001706:Biopsy; D004452:Echocardiography; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005350:Fibroma / Q000150:complications* / Q000175:diagnosis; D006338:Heart Neoplasms / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007262:Infusions, Intravenous; D020766:Intracranial Embolism / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D010291:Paresis / Q000209:etiology; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator