Myxoma embolization during electroconvulsive therapy. An unusual presentation

Asaf Miller; Hanna Amouri; Maged Makhoul; Benjamin Medalion; Ofer Shamgar; Jon Lessik; Galia Ronen; Tzah Feldman; Yizhak Shiller; Oren Caspi

doi:10.1016/j.jstrokecerebrovasdis.2024.107916

Myxoma embolization during electroconvulsive therapy. An unusual presentation

J Stroke Cerebrovasc Dis. 2024 Nov;33(11):107916. doi: 10.1016/j.jstrokecerebrovasdis.2024.107916. Epub 2024 Aug 12.

Authors

Asaf Miller¹, Hanna Amouri², Maged Makhoul³, Benjamin Medalion³, Ofer Shamgar⁴, Jon Lessik⁵, Galia Ronen⁶, Tzah Feldman⁷, Yizhak Shiller⁸, Oren Caspi⁵

Affiliations

¹ Medical Intensive Care Unit, Rambam Health Care Campus, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel. Electronic address: asafmiller@gmail.com.
² Medical Intensive Care Unit, Rambam Health Care Campus, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
³ Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel.
⁴ Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Psychiatry, Rambam Health Care Campus, Haifa, Israel.
⁵ Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
⁶ Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Radiology, Rambam Health Care Campus, Haifa, Israel.
⁷ Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel; Pathology Laboratory, Rambam Health Care Campus, Haifa, Israel.
⁸ Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Neurology, Rambam Health Care Campus, Haifa, Israel.

PMID: 39142609
DOI: 10.1016/j.jstrokecerebrovasdis.2024.107916

Abstract

We describe a comatose female patient after electroconvulsive therapy. Head imaging showed diffuse cerebral emboli. Transesophageal echocardiography showed left atrial myxoma which was resected soon thereafter. The article describes the presentation, complications and treatment of myxomas and discusses electroconvulsive therapy, its adverse events and the possible relation to myxoma embolization.

Keywords: Electroconvulsive therapy; Embolization; Myxoma; Stroke.

Publication types

Case Reports

MeSH terms

Cardiac Surgical Procedures / adverse effects
Coma / etiology
Coma / therapy
Echocardiography, Transesophageal*
Electroconvulsive Therapy* / adverse effects
Female
Heart Atria / diagnostic imaging
Heart Neoplasms* / complications
Heart Neoplasms* / diagnostic imaging
Heart Neoplasms* / therapy
Humans
Intracranial Embolism* / diagnostic imaging
Intracranial Embolism* / etiology
Intracranial Embolism* / therapy
Middle Aged
Myxoma* / complications
Myxoma* / diagnostic imaging
Treatment Outcome