A rare cause of transient ischaemic attack in a young man: cardiac papillary fibroelastoma

We describe a case of cardiac papillary fibroelastoma (CPF) causing a transient ischaemic attack in a 32-year-old man. The diagnosis was established by echocardiography.

Transoesophageal echocardiography revealed a solid mass 7×8 mm in size on the primary chordae of the mitral valve (Figure 1A, Moving image 1). The tumour was resected from the primary chordae of the anterior mitral valve leaflet, including the extension beneath the chordae tissue, and was removed under cardiopulmonary bypass (Figure 1B).

Figure 1. A) Transthoracic image showing a mobile mass of the mitral valve chordae. B) Operative view of the tumour of the primary chordae of the mitral A2 scallop. C) Macroscopic view of the tumour which shows papillary projections.

The postoperative course was uneventful. Histologic examination was consistent with CPF. CPFs are usually benign and can cause neurological embolic events (Figure 1C). Thus, surgical resection should be performed regardless of the size of these tumours in both symptomatic and asymptomatic patients, because the successful complete resection of CPF is curative and the long-term postoperative prognosis is excellent. CPF should be kept in mind as a possible cause during transient ischaemic attack (TIA) in young adults.

Conflict of interest statement

The authors have no conflicts of interest to declare.

Online data supplement

Moving image 1. Transoesophageal echocardiography reveals an isolated mass of the mitral valve chordae.

Supplementary data

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