title: Papillary fibroelastoma of the aortic valve presenting with chronic angina and acute stroke: a case report.
abstract: BACKGROUND
  Papillary fibroelastomas are rare, benign cardiac tumors that are often found on cardiac valvular surfaces. Most are incidental discoveries during surgery or autopsy. The clinical presentation of fibroelastoma varies widely, ranging from clinically asymptomatic to severe thromboembolic events.
  
  
  METHODS
  We report a case of 65-year-old white man diagnosed with scattered, bilateral acute cerebral hemisphere infarcts with a history of chronic angina. Transesophageal echocardiography identified a fibroelastoma on the right coronary cusp of the aortic leaflet. Cardiac catheterization revealed mild non-obstructive stenosis. We postulate that the etiology of his angina is related to the dynamic occlusion of his right coronary ostium by the fibroelastoma.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first case report describing a patient with a cardiac papillary fibroelastoma who presented with both chronic angina and acute stroke.
authors.affiliation: Department of Internal Medicine, Brookdale University Hospital and Medical Center, One Brookdale Plaza, Brooklyn, NY, 11212, USA. fzhang8886@gmail.com.
authors.forename: Fan
authors.identifier: http://orcid.org/0000-0002-5731-0320
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Internal Medicine, Brookdale University Hospital and Medical Center, One Brookdale Plaza, Brooklyn, NY, 11212, USA.
authors.forename: Ziqiang
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Department of Internal Medicine, Brookdale University Hospital and Medical Center, One Brookdale Plaza, Brooklyn, NY, 11212, USA.
authors.forename: Gautham K
authors.initials: GK
authors.lastname: Upadhya
authors.affiliation: Department of Pathology, New York-Presbyterian/Queens, Flushing, NY, 11355, USA.
authors.forename: Jiankun
authors.initials: J
authors.lastname: Tong
authors.affiliation: Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, One Brookdale Plaza, Brooklyn, NY, 11212, USA.
authors.forename: Vlad
authors.initials: V
authors.lastname: Gotlieb
authors.affiliation: Division of Cardiology, Brookdale University Hospital and Medical Center, One Brookdale Plaza, Brooklyn, NY, 11212, USA.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Khan
authors.affiliation: Division of Cardiology, New York-Presbyterian/Queens, Flushing, NY, 11355, USA.
authors.forename: Rakesh P
authors.initials: RP
authors.lastname: Gupta
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000209:etiology*; D001021:Aortic Valve / Q000000981:diagnostic imaging; D017548:Echocardiography, Transesophageal; D005350:Fibroma / Q000150:complications* / Q000000981:diagnostic imaging; D006338:Heart Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging; D006349:Heart Valve Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging; D008297:Male; D020521:Stroke / Q000209:etiology*
keywords: Acute stroke; Angina; Aortic valve; Cardiac tumor; Case report; Papillary fibroelastoma