A 48-year-old woman presented to the hospital with a 3-week history of dyspnea, chest pain, productive cough, and intermittent low-grade fevers. She denied weight loss, night sweats, or hemoptysis. She acknowledged recent IV heroine and cocaine use and a 12-pack-year history of cigarette smoking. Her only tuberculosis risk factor was a period of imprisonment 6 years prior to presentation.
1Burke, A, Virmani, R (1996) Tumors of the heart and great vessels.Atlas of tumor pathology. Third Series. Fascicle 16,47-53 Armed Forces Institute of Pathology. Washington, DC: 2Chiles, C, Woodard, PK, Gutierrez, FR, et al Metastatic involvement of the heart and pericardium: CT and MR imaging.Radiographics2001;21,439-4493Colucci, V, Alberti, A, Bonacina,, et al Papillary fibroelastoma of the mitral valve: a rare cause of embolic events.Tex Heart Inst J1995;22,327-3314Gowda, RM, Khan, IA, Nair, CK, et al Cardiac papillary fibroelastoma: a comprehensive analysis of 725 cases.Am Heart J2003;146,404-4105Gulati, G, Sharma, S, Kothari, SS, et al Comparison of echo and MRI in the imaging evaluation of intracardiac masses.Cardiovasc Intervent Radiol2004;27,459-4696Kasarskis, EJ, O’Connor, W, Earle, G Embolic stroke from cardiac papillary fibroelastomas.Stroke1988;19,1171-11737Klarich, KW, Enriquez-Sarano, M, Gura, GM, et al Papillary fibroelastoma: echocardiographic characteristics for diagnosis and pathologic correlation.J Am Coll Cardiol1997;30,784-7908McAllister, HA, Jr, Fenoglio, JJ, Jr Tumors of the cardiovascular system.Atlas of tumor pathology. Second Series. Fascicle 151978,20-25 Armed Forces Institute of Pathology. Washington, DC: 9Neerukonda, SK, Jantz, RD, Vijay, NK, et al Pulmonary embolization of papillary fibroelastoma arising from the tricuspid valve.Tex Heart Inst J1991;18,132-13510Reynen, K Frequency of primary tumors of the heart [letter].Am J Cardiol1996;77,10711Sun, JP, Asher, CR, Yang, XS, et al Clinical and echocardiographic characteristics of papillary fibroelastomas: a retrospective and prospective study in 162 patients.Circulation2001;103,2687-269312Takada, A, Saito, K, Ro, A, et al Papillary fibroelastoma of the aortic valve: a sudden death case of coronary embolism with myocardial infarction.Forensic Sci Int2000;113,209-21413Waltenberger, J, Thelin, S Images in cardiovascular medicine: papillary fibroelastoma as an unusual source of repeated pulmonary embolism [abstract].Circulation1994;89,2433