Papillary Fibroelastoma Found With Transesophageal Echocardiography After a Normal Transthoracic Echocardiography. (September 2017)

• Record Type: Journal Article
• Authors: Cook, Andrew G.; Viswanath, Omar; D'Mello, Jayanand
• Is Part Of: Seminars in cardiothoracic and vascular anesthesia. Volume 21:Number 3(2017:Sep.)
• Page Start: 217
• Page End: 220
• Publication Date: 2017-09
• Subjects: cardiac tumors -- transthoracic echocardiogram -- transesophageal echocardiogram -- coumadin ridge -- papillary fibroelastoma; Cardiovascular system -- Surgery -- Methods -- Periodicals; Chest -- Surgery -- Methods -- Periodicals; Anesthesia -- Periodicals; Anesthetics -- Periodicals; Anesthesia -- Periodicals; Anesthetics -- Periodicals; Cardiovascular Surgical Procedures -- methods -- Periodicals; Thoracic Surgical Procedures -- methods -- Periodicals; 617.96
• DOI: 10.1177/1089253217699281
• Languages: English
• ISSNs: 1089-2532

Abstract

We present the case of a patient with transient ischemic attacks who was being investigated for multiple embolic strokes. Initial workup, including brain computed tomography, computed tomography angiography, and transthoracic echocardiography (TTE) were negative for a source until transesophageal echocardiography (TEE) found a mass in the left atrium. The TEE differentiated the mass as a rare cardiac papillary fibroelastoma on the left atrial free wall confirmed by postsurgical pathology. This case highlights the importance of TEE as a diagnostic tool for its ability to more accurately differentiate and characterize the tumor compared with TTE. This case underscores that a negative TTE does not equate to zero risk of the presence of a cardiac tumor. It is prudent for the clinician to be cognizant that it may be beneficial to perform a TEE even with a negative TTE workup.