A case report of left atrial myxoma presenting as embolic stroke.

Key Clinical Message: Embolic stroke may rarely be the first presenting symptom of atrial myxoma. Multiple infarcts should be evaluated for embolic causes. Correct etiological diagnosis in cardio-embolic stroke guides proper management strategy. It reinforces on the importance of early echocardiogram in the initial evaluation of patients presenting with ischemic stroke. Abstract: Atrial myxoma is a benign cardiac tumor found most commonly in the left atrium in 80% of the cases. Almost 1 in 10 myxomas are familial and are most common in women. Cardiac myxoma mostly present with dyspnea, fatigue, or palpitations. Previously undiagnosed left atrial myxoma (LA) presenting as stroke is extremely rare. Authors describe the case of a middle-aged man with LA myxoma presenting with acute ischemic embolic stroke that was surgically excised. This case report emphasizes on the rare presentation as embolic stroke and the role of cardiac imaging in patients presenting with ischemic stroke. Early and coordinated teamwork among the neurologist, cardiologist, and cardiothoracic surgeon help establish the etiology and provide appropriate treatment.

Unusual mass in the heart: A case report.

Carcinoma lung is a concerning cause of mortality worldwide. Approximately half of the cases are metastatic at diagnosis and uncommon metastatic sites confer a worse prognosis. Intracardiac metastasis from lung cancer is rare and limited to a few case reports. The authors describe the case of a 54-year female with left ventricular cavity mass as one of the rarest presentations of lung malignancy. She presented to the cardiology outpatient department with a history of progressive dyspnea for the last two months. Her 2D echocardiogram showed a large heterogeneous mass in the left ventricle cavity along with gross pericardial and pleural effusion. CT guided lung biopsy revealed adenocarcinoma of the lung. The patient was started on tablet geftinib along with other supportive therapy, while awaiting reports of next generation sequencing (NGS) for mutation analysis and immunohistochemistry. However, the patient's condition rapidly worsened and she succumbed to death within one week of hospital admission. Cardiac metastasis is one of the rarest sites for lung cancer spread. Intracavitary metastasis as in our case is an extremely rare presentation. Treatment is not yet well defined for such cases and it carries a poor prognosis despite available therapies. This case required multidisciplinary approach with involvement of cardiologist, oncologist, pulmonologist and intensivists. Further research is required to help define better treatment options.

Transient myeloproliferative disorder and eosinophilic pericardial effusion in a down syndrome neonate.

Transient myeloproliferative disorder seen in neonates with Down syndrome is often thought to have a benign course. The authors describe the clinical and laboratory profile of a neonate with Down phenotype and transient myeloproliferative disorder with pericardial effusion as co-morbidity. Pericardial fluid analysis showed eosinophils. Pericardial effusion resolved with prednisolone therapy. Regression in hepatosplenomegaly with clearance of blasts was seen by third week of illness. The clinical course suggested a benign infiltration of the pericardium. Presence of eosinophils supports the differentiating capability of the blast cells in transient myeloproliferative disorders.