Dynamic obstruction of right coronary ostium by a papillary fibroelastoma: a case report on alternative causes of chest pain and cardiac imaging assessment

乳头状纤维弹性瘤动态阻塞右冠状动脉开口:胸痛及心脏影像学评估的替代病因病例报告

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Abstract

BACKGROUND: Papillary fibroelastomas (PFEs) are one the most common primary cardiac tumours. Although they are benign, their location involves a high risk of adverse events, which have been reported mainly in the form of embolic events, but angina pectoris is another possible, less frequent manifestation. CASE SUMMARY: We present a case of a 72-year-old woman with chest pain symptoms, who was found to have a PFE. As part of pre-operatory study a computed tomography (CT) scan was performed which documented dynamic obstruction of the right coronary artery. Surgery was brought forwards and mass was resected with histology confirming PFE. DISCUSSION: The interest of our case lies into the documentation of the obstruction with the scan, highlighting the role and advancements of this diagnostic technique and the importance of a prompt assessment and management of these patients, since previous clinical evidence has shown that ischaemia due to PFEs could present with acute coronary syndromes or even sudden cardiac death.

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