Atrial myxoma presenting as acute ischaemic stroke and chronic right lower leg claudication

Abstract

A 48-year-old man presented with acute onset of left facial numbness, ataxic gait and double vision He also complained of chronic right lower leg pain with acute onset a year prior to presentation His vital signs were within normal limits Physical exam was notable for right-sided intranuclear opthalmoplegia, decreased sensation to light touch on the left side of his body, left-sided dysmetria and ataxic gait Neuroimaging showed evidence of acute stroke in the cerebellum and brainstem, for which he was treated with thrombolytics An echocardiogram revealed a 5×3 cm left atrial myxoma, which was surgically resected Subsequent imaging of his lower extremity revealed a chronic common iliac artery occlusion for which he underwent angioplasty His claudication symptoms resolved, and he was without any neurological deficits at a 2-year follow-up visit.