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Left ventricular thrombus in a patient with recurrent ischemic stroke events—The role of echocardiography

KEY CLINICAL MESSAGE: Cardiac ultrasound is recommended in investigating ischemic stroke events. There is increasing evidence that direct oral anticoagulants can be safely used instead of vitamin K antagonists in the setting of left ventricular thrombus. ABSTRACT: Cardioembolic stroke is responsible...

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Autores principales: Stylianou, Vasiliki Vanesa, Tsampasian, Vasiliki, Pavlou, Marios, Georgiou, Panagiota, Patestos, Dimitrios, Kapetis, Lorentzos, Vassiliou, Vassilios S., Eftychiou, Christos, Tsielepis, Michalis, Bazoukis, George
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10151600/
https://www.ncbi.nlm.nih.gov/pubmed/37143461
http://dx.doi.org/10.1002/ccr3.7300
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author Stylianou, Vasiliki Vanesa
Tsampasian, Vasiliki
Pavlou, Marios
Georgiou, Panagiota
Patestos, Dimitrios
Kapetis, Lorentzos
Vassiliou, Vassilios S.
Eftychiou, Christos
Tsielepis, Michalis
Bazoukis, George
author_facet Stylianou, Vasiliki Vanesa
Tsampasian, Vasiliki
Pavlou, Marios
Georgiou, Panagiota
Patestos, Dimitrios
Kapetis, Lorentzos
Vassiliou, Vassilios S.
Eftychiou, Christos
Tsielepis, Michalis
Bazoukis, George
author_sort Stylianou, Vasiliki Vanesa
collection PubMed
description KEY CLINICAL MESSAGE: Cardiac ultrasound is recommended in investigating ischemic stroke events. There is increasing evidence that direct oral anticoagulants can be safely used instead of vitamin K antagonists in the setting of left ventricular thrombus. ABSTRACT: Cardioembolic stroke is responsible for an increasing number of ischemic strokes. Compared to other causes of stroke, cardioembolic strokes affect a larger brain area. Left ventricular (LV) thrombi account for up to 10% of cardioembolic strokes. It is essential to identify patients at high risk of LV thrombus formation, such as patients with a history of myocardial infarction, patients with reduced ejection fraction, or patients with cardiomyopathies. We present a patient with an ischemic stroke, and the cardiac ultrasound revealed a reduced ejection fraction and the presence of LV thrombus at the apex. The patient had no prior history of cardiovascular diseases. Even in a resource‐limited setting, cardiac ultrasound is recommended to investigate stroke or transient ischemic attack events, especially in patients with a prior history of myocardial infarction. Although patients with LV thrombus should be treated with oral anticoagulants for at least 3 months, the role of direct oral anticoagulants and the optimal period of anticoagulation in this setting needs further investigation.
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spelling pubmed-101516002023-05-03 Left ventricular thrombus in a patient with recurrent ischemic stroke events—The role of echocardiography Stylianou, Vasiliki Vanesa Tsampasian, Vasiliki Pavlou, Marios Georgiou, Panagiota Patestos, Dimitrios Kapetis, Lorentzos Vassiliou, Vassilios S. Eftychiou, Christos Tsielepis, Michalis Bazoukis, George Clin Case Rep Case Report KEY CLINICAL MESSAGE: Cardiac ultrasound is recommended in investigating ischemic stroke events. There is increasing evidence that direct oral anticoagulants can be safely used instead of vitamin K antagonists in the setting of left ventricular thrombus. ABSTRACT: Cardioembolic stroke is responsible for an increasing number of ischemic strokes. Compared to other causes of stroke, cardioembolic strokes affect a larger brain area. Left ventricular (LV) thrombi account for up to 10% of cardioembolic strokes. It is essential to identify patients at high risk of LV thrombus formation, such as patients with a history of myocardial infarction, patients with reduced ejection fraction, or patients with cardiomyopathies. We present a patient with an ischemic stroke, and the cardiac ultrasound revealed a reduced ejection fraction and the presence of LV thrombus at the apex. The patient had no prior history of cardiovascular diseases. Even in a resource‐limited setting, cardiac ultrasound is recommended to investigate stroke or transient ischemic attack events, especially in patients with a prior history of myocardial infarction. Although patients with LV thrombus should be treated with oral anticoagulants for at least 3 months, the role of direct oral anticoagulants and the optimal period of anticoagulation in this setting needs further investigation. John Wiley and Sons Inc. 2023-05-01 /pmc/articles/PMC10151600/ /pubmed/37143461 http://dx.doi.org/10.1002/ccr3.7300 Text en © 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Case Report
Stylianou, Vasiliki Vanesa
Tsampasian, Vasiliki
Pavlou, Marios
Georgiou, Panagiota
Patestos, Dimitrios
Kapetis, Lorentzos
Vassiliou, Vassilios S.
Eftychiou, Christos
Tsielepis, Michalis
Bazoukis, George
Left ventricular thrombus in a patient with recurrent ischemic stroke events—The role of echocardiography
title Left ventricular thrombus in a patient with recurrent ischemic stroke events—The role of echocardiography
title_full Left ventricular thrombus in a patient with recurrent ischemic stroke events—The role of echocardiography
title_fullStr Left ventricular thrombus in a patient with recurrent ischemic stroke events—The role of echocardiography
title_full_unstemmed Left ventricular thrombus in a patient with recurrent ischemic stroke events—The role of echocardiography
title_short Left ventricular thrombus in a patient with recurrent ischemic stroke events—The role of echocardiography
title_sort left ventricular thrombus in a patient with recurrent ischemic stroke events—the role of echocardiography
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10151600/
https://www.ncbi.nlm.nih.gov/pubmed/37143461
http://dx.doi.org/10.1002/ccr3.7300
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