A 37-year-old woman with a two-year history of joint pains, fevers, and a skin rash, collapsed suddenly. Clinically she demonstrated aphasia, a right hemiparesis, and right hyperreflexia. A left central retinal artery occlusion was noted. No cardiac murmurs were present. At autopsy, an unsuspected left atrial myxoma was found with embolization to the left middle cerebral artery, left posterior ciliary arteries, left choroid, and probably left retinal arteries. This represents at least the sixth case of atrial myxoma and central retinal artery occlusion; the clinical features of these cases are strikingly similar. Atrial myxoma should be suspected in any young person with central retinal artery occlusion without predisposing disease.
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