Cor triatriatum and stroke.
Jose Danilo Bengzon DiestroJoseph Justin Hipolito RegaldoEddieson Masangcay GonzalesMaria Kristina Casanova DorotanAdrian Isidro EspirituJose Leonard Rivera PascualPublished in: BMJ case reports (2017)
Cor triatriatum sinistrum (CTS) is a congenital anomaly where the left atrium is divided into two compartments by a fibromuscular membrane. This report aims to add to the literature on a rare cardiac condition that can cause neurological morbidity. We report a case of a 19-year-old female with an infarct in the right middle cerebral artery (MCA) territory initially maintained on aspirin. Eighteen months later, she had recurrence of weakness, for which repeat transthoracic echocardiography (TTE) and re-evaluation of the first TTE demonstrated a hyperechoic membrane spanning the width of the left atrium, clinching the diagnosis of CTS. Despite anticoagulation with apixaban, she was admitted for a third stroke where she succumbed to hospital-acquired pneumonia. Among cases of CTS associated with stroke, anticoagulation and surgery were the main modes of treatment. This case has the longest follow-up and the first to demonstrate failure of antiplatelet therapy and anticoagulation.
Keyphrases
- atrial fibrillation
- antiplatelet therapy
- percutaneous coronary intervention
- left atrial appendage
- catheter ablation
- middle cerebral artery
- venous thromboembolism
- acute coronary syndrome
- coronary artery bypass
- acute myocardial infarction
- heart failure
- minimally invasive
- left ventricular
- pulmonary artery
- inferior vena cava
- low dose
- systematic review
- vena cava
- computed tomography
- internal carotid artery
- healthcare
- cardiovascular events
- coronary artery disease
- intensive care unit
- cardiovascular disease
- type diabetes
- acute care
- myasthenia gravis
- adverse drug