Asymptomatic papillary fibroelastoma of the aortic valve

Abstract: A previously healthy 63-year-old woman with multiple risk factors for coronary artery disease was referred to the outpatient clinic with a three-month history of atypical chest pain. At physical examination no abnormalities could be detected and the ECG was completely normal. At transthoracic echocardiography and transoesophageal echocardiography a mass, 1 cm in diameter and attached to the right coronary cusp of the aortic valve, was detected. The mass had the echocardiographic appearance of a nonhomogeneous, round, dense, mobile structure, typical features of a fibroelastoma (figure 1). On dipyridamole-thallium scintigraphy, no coronary insufficiency could be demonstrated. Since cardiac papillary fibroelastomas are associated with a risk of thromboembolic events, the patient underwent complete tumour excision by a simple shave excision (figure 2).