Giant atrial myxoma leading to stroke

A previously healthy 45‐year‐old woman presented with a history of sudden‐onset right hemiparesis and dysarthria while walking. Physical examination, including of the cardiovascular system, was unremarkable apart from the neurological deficit. A magnetic resonance imaging scan of the brain showed high signal lesions in the left middle cerebral artery territory (Figure, A), confirming a recent infarction probably of embolic origin. The electrocardiogram was normal, but the echocardiogram (Figure, B and C) showed a left atrial solid mass (atrial myxoma [AM]) that occupied part of the left atrium (LA) during systole (Figure, B) and prolapsed into the left ventricle (LV) during diastole (Figure, C). The mass was excised 30 days after the stroke and the diagnosis of a giant (6.4 × 3.6 cm) atrial myxoma was confirmed (Figure, D). At 12‐months’ follow‐up, the patient had mild hemiparesis, normal speech, and no cardiac dysfunction. Stroke in young adults is less frequent and has different aetiologies compared with older individuals. Atrial myxoma is the most common cardiac tumour1 and needs consideration when investigating younger patients with stroke.