Acute ischemic stroke in young adult: Atrial fibrillation, hyperthyroidism, and COVID-19 collaboration

Atrial fibrillation is a frequently detected cardiac arrhythmia in the etiology of ischemic stroke. The incidence of atrial fibrillation and the risk of it causing ischemic stroke increase significantly with age; it is rare in young people. It is known that the risk of developing atrial fibrillation is high when there is a background of hyperthyroidism. COVID-19 is thought to cause thromboembolic events, cardiac pathologies, and endocrine disorders. A 54-year-old presented with right-sided hemiplegia and motor aphasia of 1.5 h duration. On evaluation, he tested positive for SARS-CoV-2 imaging was suggestive of acute pons ischemia and found to have hyperthyroidism and atrial fibrillation. It is clear that atrial fibrillation, which is highly unlikely to cause ischemic stroke in young adults, may develop due to hyperthyroidism. COVID-19 has been suggested as a cause of atrial fibrillation and hyperthyroidism. It is also thought to be involved in the etiology of stroke by causing hypercoagulation or triggering vasoconstriction through the renin–angiotensin system.