Abstract
A 69 year-old man, suffering from multiple cerebral embolisms with symptoms of sudden onset aphasia and right hemiparesis, was transferred to our hospital for convalescent rehabilitation on day 38. Cardioembolic stroke was presumed to be the pathogenesis of his stroke, however, embolic sources could not be detected in the initial examinations during acute phase hospitalization. To prevent against recurrence of stroke, anticoagulant therapy was administered considering the possibility of paroxysmal atrial fibrillation. In the process of re-evaluation in the convalescent rehabilitation ward, a mobilizing mass in the left atrium was detected by transthoracic echocardiography on day 40. Suspected as cardiac myxoma, he was transferred for emergency cardiovascular surgery. The mass was surgically resected on day 55, and was confirmed pathologically as myxoma. Although cardiac myxoma is quite rare, it should not be excluded as an embolic source in cases of multiple cerebral embolisms of unknown origin. Repeated evaluation during convalescence and maintenance period is needed for appropriate diagnosis and treatment.
