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A patient with recurrent strokes: multimodal imaging reveals two possible causes

Sorin Giusca

Sorin Giusca

  • Department of Cardiology & Vascular Medicine, GRN Hospital WeinheimGermany
  • Weinheim Imaging Center, Hector FoundationWeinheim, Germany
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Giusca, Sorin
, 
Johannes Schreck

Johannes Schreck

Institute of Pathology, University of HeidelbergHeidelberg, Germany
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Schreck, Johannes
, 
Matthias Karck

Matthias Karck

Department of Cardiac Surgery, University of HeidelbergHeidelberg, Germany
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Karck, Matthias
 and 
Grigorios Korosoglou

Grigorios Korosoglou

  • Department of Cardiology & Vascular Medicine, GRN Hospital WeinheimGermany
  • Weinheim Imaging Center, Hector FoundationWeinheim, Germany
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Korosoglou, Grigorios
  
Sep 08, 2022
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Article Category: Case Report
Published Online: Sep 08, 2022
Page range: 125 - 129
DOI: https://doi.org/10.2478/rjc-2022-0019
Keywords
© 2022 Sorin Giusca et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

A - Transesophageal echocardiography at 120°. Note the structure (white arrow) attached to the aortic valve. B. Transesophageal echocardiography at 45°. Note the same structure attached to the right coronary cusp. C. Transesophageal echocardiography at 50°. Note the presence of a patent foramen ovale (PFO, white arrow). D. Acquisition at the same level as C after the administration of agitated saline and performance of the Valsalva maneuver. Note the crossing of air bubbles from the left atrium to the right atrium (white arrow).
A - Transesophageal echocardiography at 120°. Note the structure (white arrow) attached to the aortic valve. B. Transesophageal echocardiography at 45°. Note the same structure attached to the right coronary cusp. C. Transesophageal echocardiography at 50°. Note the presence of a patent foramen ovale (PFO, white arrow). D. Acquisition at the same level as C after the administration of agitated saline and performance of the Valsalva maneuver. Note the crossing of air bubbles from the left atrium to the right atrium (white arrow).

Figure 2

Coronary computed tomography angiography with a retrospective current modulated protocol. A, B, and C. 1.5 mm volumetric reconstructions. Note the cardiac tumor attached to the right coronary cups measuring 8 x 8 x 5 mm. D, E, and F. 0.6 mm curved radial multi planar reconstruction of the left descending coronary artery, left circumflex coronary artery, and right coronary artery, respectively.
Coronary computed tomography angiography with a retrospective current modulated protocol. A, B, and C. 1.5 mm volumetric reconstructions. Note the cardiac tumor attached to the right coronary cups measuring 8 x 8 x 5 mm. D, E, and F. 0.6 mm curved radial multi planar reconstruction of the left descending coronary artery, left circumflex coronary artery, and right coronary artery, respectively.

Figure 3

Histopathological evaluation of the cardiac tumor being concordant with the diagnosis of fibroma, as the elastin stain did not find clearly identifiable intratumoral elastin fibers. A. Hematoxylin and eosin stain. B. Elastic Van Gieson stain.
Histopathological evaluation of the cardiac tumor being concordant with the diagnosis of fibroma, as the elastin stain did not find clearly identifiable intratumoral elastin fibers. A. Hematoxylin and eosin stain. B. Elastic Van Gieson stain.
Language:
English
Publication timeframe:
4 times per year
Journal Subjects:
Medicine, Clinical Medicine, Internal Medicine, Cardiology, Pediatrics and Juvenile Medicine, Paediatric Cardiology, Surgery, Cardiac Surgery
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