{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T18:24:19Z","timestamp":1757615059052,"version":"3.44.0"},"reference-count":21,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,8,24]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>We describe a case of a woman in her 70s who presented with acute chest pain and ST-segment elevation on ECG. Multimodality cardiac imaging confirmed Takotsubo cardiomyopathy alongside a pedunculated left ventricular mass, presumed to be a thrombus, with suspected embolisation to the left anterior descending artery, triggering an acute myocardial infarction. She received guideline-directed medical therapy for heart failure and anticoagulation for the thrombus. Her ejection fraction subsequently recovered. However, after 7\u2009months of anticoagulation, serial imaging showed persistent ventricular mass, raising concern for an alternative diagnosis. Surgical resection of the mass revealed fibroelastoma, an unexpected finding given its atypical location. The initial hypothesis was revised to tumour emboli triggering the Takotsubo cardiomyopathy. This case underscores the importance of considering atypically located cardiac tumours in coronary embolisation with myocardial ischaemia, particularly in patients without traditional cardiovascular risk factors.<\/jats:p>","DOI":"10.1136\/bcr-2025-267319","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T12:55:20Z","timestamp":1757076920000},"page":"e267319","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Coronary embolisation of a left ventricular fibroelastoma mimicking a thrombus and triggering Takotsubo cardiomyopathy"],"prefix":"10.1136","volume":"18","author":[{"given":"Malika","family":"Elhage Hassan","sequence":"first","affiliation":[{"name":"J. Willis Hurst Internal Medicine Residency Program, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1337-7689","authenticated-orcid":false,"given":"Taha","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mani Ali","family":"Daneshmand","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pratik B","family":"Sandesara","sequence":"additional","affiliation":[{"name":"Interventional Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"2025090505551239000_18.9.e267319.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.027121"},{"key":"2025090505551239000_18.9.e267319.2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy076"},{"key":"2025090505551239000_18.9.e267319.3","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1161\/ATVBAHA.119.313491","article-title":"Intraventricular Thrombus Formation and Embolism in Takotsubo Syndrome: Insights From the International Takotsubo Registry","volume":"40","author":"Ding","year":"2020","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"2025090505551239000_18.9.e267319.4","doi-asserted-by":"crossref","first-page":"102421","DOI":"10.1016\/j.cpcardiol.2024.102421","article-title":"The many faces of takotsubo syndrome: A review","volume":"49","author":"Ahmed","year":"2024","journal-title":"Curr Probl Cardiol"},{"key":"2025090505551239000_18.9.e267319.5","doi-asserted-by":"crossref","DOI":"10.1002\/ccr3.9207","article-title":"Cardiac papillary fibroelastomas: Unveiling a rare right atrial presentation with surgical insights\u2014A case report and review of the literature","volume":"12","author":"Davani","year":"2024","journal-title":"Clin Case Rep"},{"key":"2025090505551239000_18.9.e267319.6","unstructured":"Devanabanda AR , Fibroelastoma L . Papillary fibroelastoma. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2025."},{"key":"2025090505551239000_18.9.e267319.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(03)00249-7"},{"key":"2025090505551239000_18.9.e267319.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.08.057"},{"key":"2025090505551239000_18.9.e267319.9","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.jaccao.2020.05.009","article-title":"Cardiac Tumors: JACC CardioOncology State-of-the-Art Review","volume":"PMCID","author":"Tyebally","year":"2020","journal-title":"JACC CardioOncol"},{"key":"2025090505551239000_18.9.e267319.10","doi-asserted-by":"crossref","unstructured":"Angeli F , Bodega F , Bergamaschi L , et al . Multimodality Imaging in the Diagnostic Work-Up of Patients With Cardiac Masses: JACC: CardioOncology State-of-the-Art Review. JACC CardioOncol 2024;847\u201362. doi:10.1016\/j.jaccao.2024.09.006","DOI":"10.1016\/j.jaccao.2024.09.006"},{"key":"2025090505551239000_18.9.e267319.11","doi-asserted-by":"crossref","first-page":"e466","DOI":"10.1016\/j.crvasa.2015.09.002","article-title":"Papillary fibroelastoma originating from the free left ventricular wall as the cause of recurrent stroke: Description of the case and literature review","volume":"58","author":"Macura","year":"2016","journal-title":"Cor Vasa"},{"key":"2025090505551239000_18.9.e267319.12","doi-asserted-by":"crossref","first-page":"2154","DOI":"10.1016\/j.jacc.2021.02.027","article-title":"Papillary Fibroelastoma Growth: A Retrospective Follow-Up Study of Patients With Pathology-Proven Papillary Fibroelastoma","volume":"77","author":"Kurmann","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2025090505551239000_18.9.e267319.13","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.case.2024.11.003","article-title":"Ticking Time Bomb: Embolic Risks and Complex Management of an Exceptionally Large Papillary Fibroelastoma","volume":"9","author":"Vincent","year":"2025","journal-title":"CASE (Phila)"},{"key":"2025090505551239000_18.9.e267319.14","doi-asserted-by":"crossref","DOI":"10.1016\/j.jaccas.2024.102719","article-title":"Cardiac Tumor Within the Left Ventricle: Thrombus or Something Else?","volume":"29","author":"Barron","year":"2024","journal-title":"JACC Case Rep"},{"key":"2025090505551239000_18.9.e267319.15","first-page":"102856","article-title":"Left Atrial Papillary Fibroelastoma Mimicking Myxoma","volume":"30","author":"Aboukhatwa","year":"2025","journal-title":"JACC: Case Reports"},{"key":"2025090505551239000_18.9.e267319.16","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.09.3369"},{"key":"2025090505551239000_18.9.e267319.17","doi-asserted-by":"crossref","DOI":"10.1016\/j.shj.2022.100154","article-title":"Cardiac Masses Discovered by Echocardiogram; What to Do Next?","volume":"7","author":"Kurmann","year":"2023","journal-title":"Struct Heart"},{"key":"2025090505551239000_18.9.e267319.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.03.569"},{"key":"2025090505551239000_18.9.e267319.19","doi-asserted-by":"crossref","first-page":"5800","DOI":"10.1097\/MS9.0000000000001371","article-title":"Cardiac papillary fibroelastoma: a rare cause of ST-segment elevation myocardial infarction: a case report","volume":"85","author":"Raheela","year":"2023","journal-title":"Ann Med Surg (Lond)"},{"key":"2025090505551239000_18.9.e267319.20","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1002\/ccr3.2954","article-title":"Coronary embolization from aortic valve fibroelastoma","volume":"8","author":"Savage","year":"2020","journal-title":"Clin Case Rep"},{"key":"2025090505551239000_18.9.e267319.21","first-page":"45","article-title":"Takotsubo syndrome triggered by coronary artery embolism in a patient with chronic atrial fibrillation","volume":"22","author":"Sakatani","year":"2020","journal-title":"J Cardiol Cases"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-267319","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T12:55:22Z","timestamp":1757076922000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-267319"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":21,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9,5]]},"published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1136\/bcr-2025-267319"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-267319","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,9]]}}}