Left Atrial Myxoma Presenting As Multiple Embolic Strokes in a Young Female: A Case Report

TL;DR

A young woman with multiple strokes was found to have a heart tumor, which was successfully removed, leading to her recovery.

Contribution

This case highlights the importance of considering cardiac causes in young patients with embolic strokes.

Findings

A left atrial myxoma was identified as the source of multiple embolic strokes in a 42-year-old woman.

Surgical removal of the myxoma led to neurological improvement with no persistent deficits.

Prompt echocardiographic evaluation is crucial for preventing recurrent embolization in such cases.

Abstract

Cardiac myxomas are rare benign tumors that can occasionally present with neurological complications due to embolic phenomena. We report a case of a 42-year-old woman who presented with sudden-onset slurred speech and transient right-sided weakness. Initial computed tomography (CT) of the brain and angiography were normal. Magnetic resonance imaging (MRI) revealed multiple small infarcts consistent with embolic strokes. Transthoracic echocardiography identified a large left atrial myxoma as the likely embolic source. The patient underwent successful surgical excision of the mass shortly after diagnosis. Neurologically, she showed progressive clinical improvement with no persistent focal deficits at postoperative follow-up, although she developed transient postoperative atrial fibrillation requiring anticoagulation. This case underscores the importance of early consideration of cardiac etiologies in young patients with multifocal embolic stroke and highlights the role of prompt echocardiographic evaluation and timely surgical management to prevent recurrent embolization.

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