Cardiac Papillary Fibroelastoma as a Cause of Sudden Cardiac Arrest

BACKGROUND: Papillary fibroelastomas (PFEs) are the most common primary tumors of the valvular surfaces of the heart. Although histopathologically benign, PFEs rarely result in catastrophic symptoms owing to their location and embolic potential. Echocardiography plays a crucial role in establishing the diagnosis of these tumors. CASE SUMMARY: A 61-year-old woman presented with witnessed cardiac arrest. After successful resuscitation, transesophageal echocardiogram showed a highly mobile mass attached to the aortic valve blocking the ostium of the left main coronary artery. After surgical removal, histopathologic evaluation revealed that the mass was a PFE. The patient was discharged in a stable condition. DISCUSSION: This is a rare case of a PFE resulting in prolonged ventricular arrhythmia, myocardial infarction, and cardiac arrest, emphasizing the need for early detection by echocardiography. TAKE-HOME MESSAGES: PFEs are benign, slow-growing tumors that may rarely manifest with life-threatening symptoms. Early detection with echocardiography followed by appropriate surgical resection can result in excellent outcomes.