A large intracardiac thrombus after a massive ischemic stroke

Giuseppina Novo, Giuseppe Vitale, Marco Marco Guglielmo, Riccardo Di Miceli, Salvatore Giambanco, Marinella Puglisi, Salvatore Novo, Pasquale Assennato

Research output: Contribution to journalArticlepeer-review

Abstract

A 87-years-old patient, with ischemic stroke, was transferred to our department for the occurrence at ECG of atrial fibrillation with rapid ventricular rate and ST segment elevation in the anterolateral leads. Brain CT showed a large ischemic area in the territory of the right middle cerebral artery. Two-dimensional transthoracic echocardiography showed apical ballooning of left ventricle, hyperkinesis of the basal segments and severe LV dysfunction with ejection fraction of 25%. These features and inconsistent troponin raise were highly suggestive of Takotsubo or stress-induced-cardiomyopathy (given the patient's frailty, coronary angiography was not performed). On the third day, echocardiography was repeated and it showed an isoechoic mass (20 × 22 mm; area 4.9 cm2) obliterating the apex, compatible with recent-onset thrombotic formation. In the following days, there was a progressive deterioration of the patient's general conditions leading to death by respiratory arrest complicated by electromechanical dissociation.

Original languageEnglish
Pages (from-to)9-10
Number of pages2
JournalActa Medica Mediterranea
Volume29
Issue number1
Publication statusPublished - 2013

Keywords

  • Atrial fibrillation
  • Intra-cardiac thrombus
  • Ischemic stroke
  • Takotsubo cardiomyopathy

ASJC Scopus subject areas

  • Medicine(all)

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