Document Detail


Papillary fibroelastomas: innocent bystanders or ignored culprits?
MedLine Citation:
PMID:  19491551     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiac papillary fibroelastomas (PFEs) are the most common tumors of the cardiac valves and the third most common cardiac tumor. They are usually detected accidentally on echocardiography, but have the potential to manifest with catastrophic embolic phenomena, resulting in stroke and myocardial infarction. Echocardiography is currently the preferred diagnostic modality, while magnetic resonance imaging and computed tomography are helpful in the differential diagnosis of cardiac tumors. The management of PFEs is empiric, as no large randomized trials have been conducted to support specific treatment guidelines. The treatment of choice for PFEs with high-risk features for peripheral embolization is surgical resection. Anticoagulation is recommended in patients who are poor surgical candidates or who refuse surgery, although its duration and intensity are debatable. This review summarizes current knowledge on the epidemiology, pathology, pathophysiology, clinical manifestations, diagnosis, and treatment of PFEs. It also highlights the need for large randomized clinical trials that would delineate more specific guidelines for managing PFEs with anticoagulation.
Authors:
Vassiliki Saloura; Petros D Grivas; A Bilal Sarwar; Paulina Gorodin; Gary S Ledley
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Postgraduate medicine     Volume:  121     ISSN:  1941-9260     ISO Abbreviation:  Postgrad Med     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-06-03     Completed Date:  2009-06-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401147     Medline TA:  Postgrad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  131-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Drexel University College of Medicine, 245 N 15th Street, Philadelphia, PA 19102, USA.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures / methods
Diagnosis, Differential
Echocardiography / methods
Embolization, Therapeutic / methods
Endocardial Fibroelastosis* / diagnosis,  epidemiology,  therapy
Female
Heart Neoplasms* / diagnosis,  epidemiology,  therapy
Humans
Incidence
Magnetic Resonance Imaging / methods
Papilloma* / diagnosis,  epidemiology,  therapy
Practice Guidelines as Topic
Prognosis
Tomography, X-Ray Computed / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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