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Rare cause of cardioembolic stroke and central retinal artery occlusion
  1. Muhamad Izzad Johari1,
  2. Mohd Noor Ismail1,
  3. Fadhilah Mohamad1 and
  4. Mohd Aizuddin Yusof2
  1. 1General Medicine, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia
  2. 2General Medicine, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
  1. Correspondence to Dr Mohd Aizuddin Yusof; aizuddinyusof{at}


Primary cardiac valve tumours are rare. This is a case report of a 32-year-old non-smoker man with a history of stroke 1 year prior and no other cardiovascular risk factors. The patient was admitted to our acute stroke ward for recurrent left hemiparesis, slurring of speech, facial asymmetry and central retinal artery occlusion. Initial laboratory investigations and ECG were normal. An urgent CT brain showed a large hypodense area at the right frontal, parietal, temporal, occipital region with effaced sulci and right lateral ventricle with midline shift and cerebral oedema in keeping with acute infarction. We proceeded with CT angiography of the cerebral and carotid on the following day, which revealed no evidence of thrombosis, aneurysm or arteriovenous malformation. There were no abnormal beaded vessels to suggest vasculitis. Transthoracic echocardiography revealed a large mobile mass in the left atrium. Meanwhile, MRI cardiac confirmed a large ill-defined mobile solid mass attached to the mitral valve’s inferoseptal component suggestive of mitral valve myxoma. This case report highlights the significance of considering a cardiogenic source of emboli in patients with large cerebral infarcts and other cardiac embolic phenomena. Imaging modalities such as echocardiography and cardiac MRI will help detect treatable conditions, such as valvular myxoma and prevent further complications.

  • stroke
  • cardiovascular medicine

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  • Contributors MIJ, MNI and FM managed the case and prepare the manuscript. MAY reviewed the manuscript and edit the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.