A rare case

28 year female presented to casualty Chief Complaints Inability to talk and right side weakness of body since 1 day. History No history of seizure ,no history of fever ,chest pain or breathlessness Not a k/c/o diabetes mellitus, hypertension. No history of major surgical procedure, no history of blood transfusion Has 2 children , age 4 yrs and 6 years. Uneventful pregnancy and delivery Not taking OC pill Vitals PR-88/min, Bp-138/76 ,spo2-99% with RA Physical Examination No Pallor,no icterus,no pedal edema,no clubbing, JVP not raised Right side plantar extensor with exaggerated knee jerk,, brocas aphasia present All other system examination is normal.. Investigations ECG- pathologic q waves in V1 and V2 leads 2D echo- 1.CAD in RWMA territory 2. Thrombus of size 2.5×1.5 cm2 attached to mid interventricular septum of left ventricle and 1.5×1.5 cm2 attached to apex of LV NCCT brain- left gangliocapsular area infarct Sickling test- negative ANA hep2- negative Homocysteine level- within normal range HBsAg,HCV,ICTC- negative PT- INR- 1.05 All other rountine investigation are within normal range.. Diagnosis Kindly provide the diagnosis and suggest necessary steps for evaluation and Management of the patient.. Thank you

2 Likes

LikeAnswersShare

Myxoma. As concluded in CT Scan. A myxoma is a myxoid tumor of primitive connective tissue. It is most commonly found in the heart (and is the most common primary tumor of the heart in adults) but can also occur in other locations.

Thank u sir,,but on 2D echo they have given it as thrombus in left ventricle.
0

Myxoma. As concluded in the CT Scan. A myxoma is a myxoid tumor of primitive connective tissue. It is most commonly found in the heart (and is the most common primary tumor of the heart in adults) but can also occur in other locations. About 10% of myxomas are inherited, as in Carney syndrome. Operative treatment is urgently required.. Echo cardiogram.. Consult Cardio Thoracic surgeon.

This acute infarct causes Rt. Side9 hemiparesis you should have to prescribe low molecular weight heparin With inj. Neurocetam BD With inj. Neurokind OD & advised MRI of brain after 24 hour with neurosurgeon consultation & regarding Myxoma I follow Dr. dineshchandra sharma