VCOM Louisiana Research Day Program

Clinical & Case Studies

David T. Crossland, BS; Rolf Morstead, MD Edward Via College of Osteopathic Medicine-Louisiana; St. Francis Medical Center 13 PAPILLARY FIBROELASTOMA: CASE STUDY AND DISCUSSION OF FUTURE TREATMENT OPTIONS

Papillary fibroelastoma (PFE) is a rare primary cardiac tumor that can have variable presentations ranging from asymptomatic to fatal complications. Much controversy surrounds etiology, and continuous discussion aids in further discovery. Here, we describe a case of an 80-year-old white female who presented with complaints of weakness and blurred vision. A CT scan of the head was done, and she was found to have a possible atraumatic subdural as well as a subarachnoid hemorrhage. Upon further review, it was decided that patient had had multiple strokes, one of which resulted in the hemorrhagic conversion that was seen on the CT. A transthoracic echocardiogram (TTE) was also done and showed nothing of note. Upon medical stabilization, the patient was transferred in the same hospital to acute inpatient rehab where she worked toward recovery. A few weeks later the patient returned with another acute infarct that involved the cervical cord and extended from the T3 to T4 level. It was at this point that cardiothoracic surgery was consulted and a transesophageal echocardiogram (TEE) was done searching for a cardioembolic source. The TEE revealed a PFE on the aortic valve. Due to the age and health status of the patient, the family decided surgical intervention was unsafe, therefore deciding against it. Although surgery

is usually curative when it comes to benign cardiac tumors, the cardiothoracic surgeon was extremely reluctant because of how unstable the patient was and the myriad of potential postoperative complications. Recognizing the role of cardiac causes of embolic ischemic events is extremely important when approaching patients potentially at risk.

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