# A Rare Case of Cardiac Myxoma With Moyamoya Phenomenon: A Disease or Syndrome?

## TL;DR

This paper presents a rare case where a cardiac myxoma may be linked to the moyamoya phenomenon, suggesting a possible connection between the two conditions.

## Contribution

The paper reports a rare case linking cardiac myxoma with moyamoya phenomenon, suggesting a potential syndrome rather than a coincidental association.

## Key findings

- The patient was diagnosed with moyamoya disease and later with cardiac myxoma.
- The moyamoya phenomenon resolved after surgical removal of the myxoma.
- This case suggests a possible syndrome involving both conditions.

## Abstract

Moyamoya disease (MMD) is a rare, idiopathic, progressive, obstructive, vasculopathy affecting primarily the terminal portions of the intracerebral internal carotid arteries, typically at the base of the brain. It is more commonly seen in people of East Asian descent. The moyamoya phenomenon refers to the characteristic appearance of the tangle of fine blood vessels, also described as a puff of smoke. Moyamoya syndrome (MMS) refers to the constriction-induced chronic brain ischemia that is believed to cause overexpression of proangiogenic factors, creating a fragile network of collateral capillaries. MMS refers to the moyamoya phenomenon in the presence of other congenital or acquired disorders. Intracerebral hemorrhage is the leading cause of death for MMS patients. Overall, the prognosis is variable. Cardiac myxoma can cause embolization of tumor cells, plaques, and thrombus, and recurrent thromboembolism can lead to chronic brain ischemia, which can lead to the development of collaterals. There have been cases reported where the moyamoya phenomenon resolved following myxoma resection. Here, we present the case of a female who had intraventricular bleeding and was diagnosed with MMD. Eighteen months later, she presented with shortness of breath and was diagnosed with cardiac myxoma with multiple valvular regurgitations. The myxoma was surgically removed.