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Case Reports in Cardiology
Volume 2017 (2017), Article ID 8185601, 4 pages
Case Report

Papillary Fibroelastoma as a Cause of Cardiogenic Embolic Stroke in a β-Thalassemia Patient: Case Report and Literature Review

1Saint Louis University School of Medicine, 1402 S Grand Blvd, Saint Louis, MO 63104, USA
2Department of Internal Medicine, SSM St. Mary’s Health Center, 6420 Clayton Rd, Richmond Heights, MO 63117, USA
3Department of Cardiothoracic Surgery, SSM St. Mary’s Health Center, 6420 Clayton Rd, Richmond Heights, MO 63117, USA
4Department of Pathology, SSM St. Mary’s Health Center, 6420 Clayton Rd, Richmond Heights, MO 63117, USA

Correspondence should be addressed to Re-I Chin

Received 18 January 2017; Accepted 19 March 2017; Published 26 March 2017

Academic Editor: Aiden Abidov

Copyright © 2017 Re-I Chin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We describe a case of a young male without stroke risk factors who presented with a sudden onset of left-sided weakness, left hand numbness, and left eye blurriness. CT scan of the head without contrast and diffusion-weighted MRI of the brain with contrast revealed an ischemic stroke in the right middle cerebral artery distribution. Transesophageal echocardiography (TEE) revealed a mobile pedunculated mass on the posterior surface of the mitral valve. This mass was resected and pathology showed a cardiac papillary fibroelastoma (CPFE), which was determined to be the cause of the patient’s cardioembolic stroke. Further workup also found that patient had microcytic anemia secondary to β-thalassemia intermedia, a rare hematologic disorder due to defective hemoglobin synthesis. Recently, another case report suggested β-thalassemia major may underlie the pathogenesis of CPFE. β-Thalassemia major causes a state of chronic inflammation and endothelial damage, which can mediate CPFE formation. Based on literature review, this is the first case report of a CPFE in a patient with β-thalassemia intermedia. This hypothesis-generating case report calls attention to the need for elucidating the relationship between CPFE and β-thalassemia in future studies to better understand the diagnosis and management of a rare cardiac tumor.