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The importance of early completion of cardiac investigations after ischaemic stroke: a case and systematic review of reperfusion therapy in stroke due to cardiac fibroelastoma

Henrietta Helliwell, Aishwarya Desai, Mark McCole, Andy Beale, Gopinath Ramadurai, Badrinathan Chandrasekaran and Gabriel SC Yiin
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DOI: https://doi.org/10.7861/clinmed.2020-0763
Clin Med November 2020
Henrietta Helliwell
AGreat Western Hospitals NHS Foundation Trust, Swindon, UK
Roles: foundation year-2 doctor in stroke medicine
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  • For correspondence: h.helliwell@nhs.net
Aishwarya Desai
BGreat Western Hospitals NHS Foundation Trust, Swindon, UK
Roles: geriatric medicine registrar
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Mark McCole
CJohn Radcliffe Hospital, Oxford, UK
Roles: consultant histopathologist
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Andy Beale
DGreat Western Hospitals NHS Foundation Trust, Swindon, UK
Roles: consultant radiologist
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Gopinath Ramadurai
EGloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
Roles: consultant stroke physician
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Badrinathan Chandrasekaran
FGreat Western Hospitals NHS Foundation Trust, Swindon, UK
Roles: consultant cardiologist
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Gabriel SC Yiin
GGreat Western Hospitals NHS Foundation Trust, Swindon, UK
Roles: consultant neurologist
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    Fig 1.

    Transthoracic echocardiography showing the fibroelastoma (white arrow) on the right coronary cusp. a) Parasternal long axis view. b) Modified four-chamber apical view. c) Normal Doppler velocity across the valve. d) Parasternal short axis view.

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    Fig 2.

    Computed tomography showing fibroelastoma (white arrow) and right aortic valve cusp (red arrow). a) Maximum intensity projection of the aortic valve showing left coronary artery ostia (LCO) and right coronary artery ostia (RCO). b) Maximum intensity projection through the aortic valve plane. c) 3D volume rendering technique of the aortic valve showing the three cusps, and the attachment of the fibroelastoma to the right coronary cusp.

  • Fig 3.
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    Fig 3.

    Haematoxylin and eosin stain of papillary fronds. a) Papillary fronds (red arrows) arising from a central stalk (black arrow) at low magnification. b) Papillary fronds showing the fibroelastic core covered with bland endothelium at higher magnification.

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The importance of early completion of cardiac investigations after ischaemic stroke: a case and systematic review of reperfusion therapy in stroke due to cardiac fibroelastoma
Henrietta Helliwell, Aishwarya Desai, Mark McCole, Andy Beale, Gopinath Ramadurai, Badrinathan Chandrasekaran, Gabriel SC Yiin
Clinical Medicine Nov 2020, 20 (6) 597-599; DOI: 10.7861/clinmed.2020-0763

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The importance of early completion of cardiac investigations after ischaemic stroke: a case and systematic review of reperfusion therapy in stroke due to cardiac fibroelastoma
Henrietta Helliwell, Aishwarya Desai, Mark McCole, Andy Beale, Gopinath Ramadurai, Badrinathan Chandrasekaran, Gabriel SC Yiin
Clinical Medicine Nov 2020, 20 (6) 597-599; DOI: 10.7861/clinmed.2020-0763
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