• Ying-Chi Shen, Kai-Chun Chang, and Jen-Jen Su.
• Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
• Medicine (Baltimore). 2024 Sep 6; 103 (36): e39088e39088.

RationaleApproximately one-fifth ischemic stroke are attributed to cardioembolism. Patients with cardioembolic stroke often develop a more severe disability and a higher risk of stroke recurrence. Cardiac myxoma, although uncommon, can serve as a potentially curable cause of acute embolic strokes.Patient ConcernsA 55-year-old male patient presented to the emergency department with acute vertigo and unsteady gait, accompanied by left upper limb numbness. Concurrently, purple-like lesions on the left hand were noticed.DiagnosesBrain magnetic resonance imaging showed multiple infarctions in the posterior circulation. Additionally, skin examination showed Janeway lesions, Osler nodes and splinter hemorrhages. There was no evidence of systemic infection. Subsequently, transthoracic echocardiogram revealed a left atrial myxoma.InterventionEarly surgical resection of cardiac myxoma was performed.OutcomesThe patient recovered well from the surgery. No recurrent embolic event was reported at 3-month postoperatively.LessonsClinicians should be vigilant for skin manifestations of cardiac embolism. In patients with acute ischemic strokes, the presence of cutaneous embolic phenomena could serve as a warning sign of cardioembolism.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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