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{
    "pk": 50489,
    "title": "When STEMI Isn’t STEMI: Cardiac Arrest from Aortic Valve Papillary Fibroelastoma – A Case Report",
    "subtitle": null,
    "abstract": "<p><strong>Introduction</strong>: Cardiac arrest remains a major global cause of mortality, with both structural and non-structural cardiac abnormalities implicated. While ischemic heart disease is a common etiology, rare conditions such as papillary fibroelastoma can also result in life-threatening events through embolization or coronary obstruction. Timely recognition and advanced cardiac imaging, particularly transesophageal echocardiography, are essential in such atypical presentations.</p>\n<p><strong>Case Report</strong>: A 61-year-old female with a history of ischemic heart disease presented to the emergency department following an out-of-hospital cardiac arrest. Initial electrocardiogram (ECG) demonstrated anterior ST-elevation myocardial infarction, which resolved on repeat ECG, prompting reconsideration of the underlying cause. The patient achieved return of spontaneous circulation twice and eventually self-extubated. Further investigation, including cardiac imaging, revealed a mobile mass on the aortic valve intermittently obstructing the left main coronary artery. The mass was surgically resected and histologically confirmed as a papillary fibroelastoma. The patient recovered fully with no neurological or cardiac complications.</p>\n<p><strong>Conclusion</strong>: This case highlights the importance of maintaining a broad differential diagnosis in patients presenting with cardiac arrest, especially when ischemic changes are transient or unexplained. Although benign, papillary fibroelastoma can lead to sudden death due to embolization or coronary obstruction. Emergency physicians should be aware of such rare but treatable causes and consider early use of advanced cardiac imaging when standard presentations do not align with the clinical picture.</p>",
    "language": "eng",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "case report"
        },
        {
            "word": "Papillary fibroelastoma"
        },
        {
            "word": "cardiac arrest"
        },
        {
            "word": "acute coronary syndrome mimic"
        },
        {
            "word": "transesophageal echocardiograph"
        }
    ],
    "section": "Case Reports",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/0px540gp",
    "frozenauthors": [
        {
            "first_name": "Mohammad Wasim",
            "middle_name": "Mohammad Zouhir",
            "last_name": "Kanaa",
            "name_suffix": "",
            "institution": "Dubai Health, Department of Emergency Medicine, Dubai, United Arab Emirates",
            "department": ""
        },
        {
            "first_name": "Shahd",
            "middle_name": "H I",
            "last_name": "Abbastanira",
            "name_suffix": "",
            "institution": "Dubai Health, Department of Emergency Medicine, Dubai, United Arab Emirates",
            "department": ""
        },
        {
            "first_name": "Essra",
            "middle_name": "Mohamed Abdullah",
            "last_name": "Elameen",
            "name_suffix": "",
            "institution": "Dubai Health, Department of Emergency Medicine, Dubai, United Arab Emirates",
            "department": ""
        },
        {
            "first_name": "Sarah",
            "middle_name": "Emad",
            "last_name": "Alsultan",
            "name_suffix": "",
            "institution": "Dubai Health, Department of Emergency Medicine, Dubai, United Arab Emirates",
            "department": ""
        }
    ],
    "date_submitted": "2025-07-26T14:55:55.674000Z",
    "date_accepted": "2025-10-21T15:38:51.337000Z",
    "date_published": "2026-01-16T23:09:00Z",
    "render_galley": null,
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            "label": "PDF",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/uciem_cpcem/article/50489/galley/48089/download/"
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}