Cardiac myxoma discovery behind chronic carotid occlusion in stroke

A 57-year-old female smoker presented with a left-sided ischemic stroke, leading to the discovery of two concurrent potential embolic sources: a chronic left internal carotid artery occlusion and a left atrial myxoma. While cardiac myxomas are known sources of cerebral emboli, this case presented a unique management challenge due to the coexisting carotid pathology. Despite successful surgical resection of the myxoma, the patient experienced a subsequent stroke one month postoperatively. This case highlights the complex clinical decision-making required when managing patients with multiple potential sources of cerebral embolism.