Author + information
- Received November 17, 2009
- Accepted November 25, 2009
- Published online June 1, 2010.
A 50-year-old African American woman presented with severe substernal chest pain and was found to have significant ST-segment elevations in the anterolateral leads. She underwent a left heart catheterization that revealed 100% stenosis of the distal left anterior descending artery, left circumflex, and obtuse marginals 1, 2, and 3 (A to D, Online Video 1). The right coronary circulation was normal, and there was no other evidence of plaque disease. This was felt to be consistent with an embolic shower. There was no evidence of right-to-left shunt or left ventricular thrombus on transthoracic echocardiography. Blood cultures and hypercoagulable workup were both negative. Transesophageal echocardiogram revealed a small mobile mass on the left coronary cusp of the aortic valve, suggestive of fibroelastoma (A to D, Online Videos 2, 3, and 4). She was taken to the operating room for surgical resection, with pathology showing fibrin deposits, felt to be consistent with fibroelastoma.
- Received November 17, 2009.
- Accepted November 25, 2009.
- American College of Cardiology Foundation