Papillary Fibroelastoma of the Aorta presenting as a Non-ST Segment Elevation Myocardial Infarction

A 42 yr female presented with atypical chest pain and was found to have a filling defect in the Sinus of Valsalva on CT angiography. Transesophageal echocardiography revealed that the defect was a mobile peculated mass with features suggestive of a fibroelastoma. She ruled in for a NSTEMI with abnormal cardiac enzymes and due to progressive chest pain coronary angiography was performed which revealed a thrombotic occlusion of the right coronary artery which was managed by percutaneous intervention. Post procedure she was managed non-operatively with aggressive systemic anticoagulation and a P2Y12 inhibitor. Interval imaging in six weeks documented a residual stump but there were no further complications.