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Kyaw Kyaw [1] and Htun Latt [2] and Sammy San Myint Aung [1] and Chanwit Roongsritong [1]
Academic Editor: Assad Movahed
1, Institute for Heart and Vascular Health, Renown Regional Medical Center, 1500 E. 2nd St. No. 302, Reno, NV 89502, USA, renown.org
2, Department of Internal Medicine, University of Nevada-Reno, School of Medicine, 1155 Mill St. No. W11, Reno, NV 89502, USA, unr.edu
Received Sep 12, 2017; Revised Nov 9, 2017; Accepted Nov 27, 2017
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Introduction
Cardiac calcified amorphous tumor (CAT) is a rare benign intracavitary tumor of the heart. Like other cardiac tumors, CAT may present with dyspnea, syncope, and pulmonary or systemic embolization and obstruction [1–4]. Herein, we are reporting a case of CAT with mitral annular calcification, who presented with acute ST-elevation myocardial infarction (STEMI) and occipital stroke. To the best of our knowledge, our case perhaps is the first description of a cardiac CAT presenting with STEMI.
2. Case Presentation
A 68-year-old woman with a 40-pack-year smoking history but no known medical problem was brought in by ambulance for sudden onset of persistent, severe left-sided chest pain without radiation. The patient also reported a new onset of blurred vision. She denied history of hypertension, dyslipidemia, diabetes mellitus, coronary artery disease (CAD), or chronic kidney disease or family history of premature CAD. Initial vital signs were normal with oxygen saturation of 98% on 2-liter supplemental oxygen via nasal cannula. Physical examination was benign, without murmur or abnormal heart sounds. There were no focal neurological deficits or signs of peripheral embolization noted. Initial electrocardiogram (EKG) showed 1-2 mm ST elevation in inferior leads (II, III, and aVF) with reciprocal ST depression in leads I and aVL (Figure 1). Oral aspirin and sublingual nitroglycerin were given immediately. Intravenous heparin was also initiated. Emergent coronary angiography showed an occlusion in one of the acute marginal branches of the right coronary artery and slow flow in the posterior descending artery. There was no other significant CAD (Figure 2). Left ventricular wall motion and systolic function were normal. Subsequent transthoracic echocardiogram (TTE) showed a 1.2 × 1.2 cm...