[Myocardial infarction and severe mitral insufficiency. Presentation of an aortic fibroelastoma]. / Infarto miocardico ed insufficienza mitralica severa. Modalità di presentazione di un fibroelastoma aortico.

We report the case of a 75-year-old female with atypical chest pain followed by non-Q wave myocardial infarction. At coronary angiography and ventriculography severe left main stenosis and severe mitral regurgitation were evidenced. Transesophageal echocardiography, performed in order to evaluate a possible mitral repair, showed an aortic tumor (11 x 14 mm in diameter) attached to the commissure between the left and non-coronary cusp, without mitral regurgitation. Cardiac magnetic resonance showed a relationship between the tumor and the left coronary ostium which explained a paroxysmal mitral regurgitation. The tumor was surgically removed and the resulting defect in the aortic leaflet was reconstructed with an autologous pericardial patch. The tumor resulted to be a papillary fibroelastoma. The clinical course was uneventful.