Recurrent ventricular fibrillation secondary to aortic valve tumor
Section snippets
Case report
A 53-year-old man was referred for evaluation of recurrent convulsive syncopal episodes. The episodes had started 2 months earlier, always occurred at rest, were preceded by chest and back discomfort, and were followed by syncope and seizures. After the seizures, the patient recovered consciousness but developed sustained hypotension that lasted for several hours. He gradually recovered without sequelae. The ECG recorded during one of these episodes showed progressive widening of the QRS in all
Discussion
Cardiac papillary fibroelastomas are the second most common primary cardiac tumor. They are benign endocardial papillomas that predominantly affect the cardiac valves, accounting for three fourths of all cardiac valve tumors.4 The aortic valve is most commonly affected, followed by the mitral valve.7, 8 Cardiac papillary fibroelastomas occur slightly more frequently in men (55%), with the highest prevalence in the eighth decade of life. The patient reported here was a 53-year-old man. Cardiac
Conclusion
Primary cardiac tumors in the aortic valve can cause ischemia and VF. The diagnosis can be difficult, and these tumors should always be considered in the differential diagnosis of sudden death.
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Papillary fibroelastoma on the aortic valve presenting as multiple cardiac arrests from electrical storm due to ischemia in patient without previous cardiac history
2019, HeartRhythm Case ReportsCitation Excerpt :The aortic valve is most commonly involved (prevalence between 35% and 63%), followed by the mitral valve (9%–35%), tricuspid valve (6%–15%), and pulmonary valve (0.5%–8%).3 Although PFE is considered histologically benign, it can cause life-threatening complications such as embolic phenomena, which range from transient ischemic attack and amaurosis fugax to acute ischemic stroke, valvular dysfunction, ventricular fibrillation, and sudden death.6 The tumor can occlude the coronary ostia or embolize into the coronary vessels, resulting in myocardial infarction, atypical angina, or VT.7 The diagnosis is usually made incidentally in asymptomatic patients who undergo echocardiography for other reasons, or the tumor can present with any of the complications previously mentioned.7
Late Diagnosis of Multiple Fibroelastomas in a 41-Year-Old Woman with Hypertrophic Cardiomyopathy and Atrial Fibrillation
2008, Journal of the American Society of EchocardiographyCitation Excerpt :Fibroelastomas have a variable clinical presentation that is location dependent. Symptoms of left-sided single fibroelastomas tend to be more severe than right-sided ones, with many reported presentations, some coincidental, including embolic stroke, sudden death, acute myocardial infarction, ventricular arrhythmias, conduction block, and transient left ventricular apical ballooning syndrome.1,10-14 In contrast, right-sided lesions are more likely to result in symptoms of congestive heart failure.15
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
2020, Clinical Medicine, Journal of the Royal College of Physicians of LondonMitral valve papillary fibroelastoma as a cause of acute coronary syndrome
2018, BMJ Case ReportsPresentation of papillary fibroelastoma of the aortic valve with atypical symptoms
2018, BMJ Case ReportsAortic valve replacement for papillary fibroelastoma
2017, Journal of Cardiac Surgery