Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 16, 2017; 5(1): 9-13
Published online Jan 16, 2017. doi: 10.12998/wjcc.v5.i1.9
Cardiac papillary fibroelastoma: The need for a timely diagnosis
Srikanth Yandrapalli, Bella Mehta, Pratik Mondal, Tanush Gupta, Pallavi Khattar, John Fallon, Randy Goldberg, Sachin Sule, Wilbert S Aronow
Srikanth Yandrapalli, Bella Mehta, Pratik Mondal, Tanush Gupta, Randy Goldberg, Sachin Sule, Department of Internal Medicine, New York Medical College at Westchester Medical Center, Valhalla, NY 10595, United States
Pallavi Khattar, John Fallon, Department of Pathology, New York Medical College at Westchester Medical Center, Valhalla, NY 10595, United States
Wilbert S Aronow, Department of Cardiology, New York Medical College at Westchester Medical Center, Valhalla, NY 10595, United States
Author contributions: Yandrapalli S, Mehta B, Mondal P, Gupta T and Goldberg R identified the cases, collected patient data, and drafted a preliminary report; Khattar P and Fallon J were involved in the pathological diagnoses, provided histopathological slides and provided guidance regarding the pathological aspects of the condition; Sule S and Aronow WS reviewed the paper and made critical changes.
Institutional review board statement: This manuscript is exempt from institutional review board committee approval.
Informed consent statement: Any information which can lead to identification of the cases has been removed.
Conflict-of-interest statement: None of the authors report any conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Wilbert S Aronow, MD, FACC, FAHA, Professor of Medicine, Department of Cardiology, New York Medical College at Westchester Medical Center, Macy Pavilion, Room 141, Valhalla, NY 10595, United States. wsaronow@aol.com
Telephone: +1-914-4935311 Fax: +1-914-2356274
Received: June 21, 2016
Peer-review started: June 24, 2016
First decision: August 11, 2016
Revised: September 3, 2016
Accepted: October 25, 2016
Article in press: October 27, 2016
Published online: January 16, 2017
Abstract

Cardiac papillary fibroelastomas (CPFs) are the second most common primary cardiac tumors and the most common cardiac valvular tumors. Although they are histologically benign and usually asymptomatic, CPFs can lead to serious and life-threatening complications like myocardial infarction, stroke, pulmonary embolus, cardiac arrest etc. CPFs represent a rare entity in clinical medicine and literature regarding their management is limited. We report two cases which illustrate such complications arising from undiagnosed CPFs on the aortic valve. We further stress on the importance of identifying CPFs early so that they can be managed appropriately based on recommendations from the available literature.

Keywords: Lambl’s excrescences, Aortic valve, Cardiac tumors, Cardiac papillary fibroelastoma, Sudden cardiac death

Core tip: The cases illustrate serious complications that can arise from an undiagnosed cardiac papillary fibroelastoma. The importance of continued investigation with a transesophageal echo when there is high clinical suspicion is explained. Current management strategies have been outlined based on available literature.