{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T07:09:27Z","timestamp":1764054567228,"version":"3.45.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Papillary fibroelastomas (PFEs) are rare benign cardiac tumours that most commonly affect the left-sided heart valves, especially the aortic valve. Although frequently asymptomatic, PFEs can cause embolic events, arrhythmias, or coronary artery occlusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 57-year-old woman with no significant medical history presented with acute chest pain and was urgently transferred to our hospital. Electrocardiography on admission showed ST-segment elevation in aVR with diffuse ST-segment depression, consistent with acute coronary syndrome (ACS). While in the emergency department, she developed a refractory ventricular fibrillation storm requiring cardiopulmonary resuscitation, intravenous amiodarone, and repeated defibrillation. Sinus rhythm was not restored, so veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was initiated in the catheterization laboratory, followed by immediate coronary angiography (CAG). CAG revealed an intracoronary mass in the left main trunk (LMT). Intravascular ultrasound (IVUS) identified a heterogeneous, mulberry-like mass occluding the LMT and protruding into the aorta. Given suspicion of a soft tissue tumour near the coronary artery origin, surgical resection was performed. Histopathology confirmed the diagnosis of PFE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case highlights the crucial role of IVUS in diagnosing rare causes of ACS, such as PFE-related coronary occlusion. IVUS can differentiate tumour from thrombus, enabling timely surgical intervention and improving clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf538","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T12:13:01Z","timestamp":1760703181000},"source":"Crossref","is-referenced-by-count":0,"title":["Acute coronary syndrome due to papillary fibroelastoma detected by intravascular ultrasound imaging: a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7272-4638","authenticated-orcid":false,"given":"Hiroto","family":"Aikawa","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine , 6-11-1 Omorinishi, Ota-ku, Tokyo 143-8541 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