Acute coronary syndrome secondary to aortic valve papillary fibroelastoma: a case report

Fibroelastoma is a rare and benign heart tumor. However, it can have serious complications. The originality of this case lies in its clinical presentation which was unusual. We, herein, report the case of a 61-year-old North African female patient, with a history of diabetes, hypertension, sleep apnea syndrome, and non explored ischemic stroke. The patient was admitted for acute coronary syndrome without ST-segment elevation at very high risk. Diagnosis of papillary fibroelastoma on the aortic valve was made based on the etiological assessment, particularly on cardiac imaging. The patient underwent surgical excision and this diagnosis was confirmed by the histopathological examination of the surgical specimen. The atypical presentation of acute coronary syndrome (ACS) was related to a complete and transient obstruction of the left main coronary artery ostium by the aortic papillary fibroelastoma. Multimodality cardiac imaging played a crucial role in the etiological diagnosis of the ACS.