A papillary fibroelastoma is generally considered pathologically benign,[4] however outflow obstruction or embolism can be associated with syncope,[5] chest pain, heart attack, stroke[6][7] and sudden cardiac death.

In particular, chest pain or syncope may be due to transient occlusion of the left main coronary artery by the tumor,[8] while a heart attack or sudden cardiac death may be due to embolization of a portion of the tumor into a coronary artery.

Histologically, papillary fibroelastomas have branching avascular papillae, composed of collagen, that are covered by endothelium.

[citation needed] If the tumor is found incidentally in an asymptomatic person, the treatment approach is controversial.

[10] If the tumor is large, greater than 1 cm in asymptomatic patients,[11] and pedunculated, a case may be made for surgical excision prior to symptoms developing due to the higher risk of embolism.