TY - JOUR
T1 - A large intracardiac thrombus after a massive ischemic stroke
AU - Novo, Giuseppina
AU - Vitale, Giuseppe
AU - Guglielmo, Marco Marco
AU - Di Miceli, Riccardo
AU - Giambanco, Salvatore
AU - Puglisi, Marinella
AU - Novo, Salvatore
AU - Assennato, Pasquale
PY - 2013
Y1 - 2013
N2 - 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.
AB - 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.
KW - Atrial fibrillation
KW - Intra-cardiac thrombus
KW - Ischemic stroke
KW - Takotsubo cardiomyopathy
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M3 - Article
AN - SCOPUS:84877964495
VL - 29
SP - 9
EP - 10
JO - Acta Medica Mediterranea
JF - Acta Medica Mediterranea
SN - 0393-6384
IS - 1
ER -