RESUMO
BACKGROUND: Atrial myxomas are very infrequent primary bening cardiac neoplasms, being considered a rare but highly fatal cause of cerebral embolism. Objectives: We describe the case of an ischemic stroke (CVA) with hemorrhagic conversion secondary to atrila myxoma as an embolic source, and its subsequent early surgical resolution. CLINICAL CASE: A 63-year-old male has a clinical episode compatible with ischemic stroke, receiving thrombolytics treatment with subsequent hemorrhagic conversion. Embolic source study show a mass compatible with cardiac myxoma in the left atrium, performing surgical resection via transeptal approach at 12 days of evolution, with repair of the interatrial defect with autologous pericardium patch. DISCUSSION: Atrial myxoma is a silent pathology and little diagnosed at its early stage, associated with events of systemic repercussion of high mortality and uncertain prognosis. Hemorrhagic cerebrovascular events constitute contraindication for anticoagulation prior to 21 days of evolution. In this case, due to the high embolic risk of myxoma, the inactivy of the bleeding was demonstrated by performing the surgery successfully on the twelfth day of evolution.