Ischemic Stroke Secondary to Left Ventricular Noncompaction

H. Yacoub, K. Sivakumar, M. El‐hunjul, Chun Chu, D. Mehta
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Abstract

Left ventricular noncompaction (LVNC) is a rare cause of cardiomyopathy that can lead to systemic embolism and ischemic stroke. LVNC results from the arrest of ventricular myocardium compaction during embryogenesis. Multiple other cardiac complications coexist with this cardiomyopathy, and one of the potential consequences is cardioembolic events causing ischemic stroke. This condition can be underdiagnosed or misdiagnosed as hypertrophic or dilated cardiomyopathy. We report a patient who presented with recurrent embolic ischemic stroke secondary to LVNC that was overlooked on initial transthoracic echocardiographic studies. After an unremarkable laboratory workup, transesophageal echocardiogram (TEE) revealed noncompaction of the myocardium within the apex of the left ventricle, confirmed by cardiac magnetic resonance imaging (MRI). The patient was anticoagulated with warfarin and discharged to a rehabilitation facility. Increased understanding and awareness of the diagnosis, clinical manifestations, and management of LVNC are advised, particularly in patients with recurrent embolic stroke of undetermined source. Screening of all first-degree relatives with this familial condition is recommended as well, as appropriate treatment can prevent cardiac complications and sudden death. J Neurol Res. 2019;9(4-5):75-80 doi: https://doi.org/10.14740/jnr553
继发于左心室非压实性脑卒中
左心室不压实(LVNC)是一种罕见的心肌病,可导致全身栓塞和缺血性中风。LVNC是由胚胎发生时心室心肌压实停止引起的。多种其他心脏并发症共存于这种心肌病,其中一个潜在的后果是心脏栓塞事件引起缺血性中风。这种情况可能被误诊为肥厚性或扩张性心肌病。我们报告了一位在最初的经胸超声心动图研究中被忽视的继发于LVNC的复发性栓塞性缺血性中风患者。经过普通的实验室检查,经食管超声心动图(TEE)显示左心室尖部心肌不致密,经心脏磁共振成像(MRI)证实。患者使用华法林抗凝并出院至康复机构。建议提高对LVNC的诊断、临床表现和管理的理解和认识,特别是对于来源不明的复发性栓塞性卒中患者。建议对患有这种家族疾病的所有一级亲属进行筛查,因为适当的治疗可以预防心脏并发症和猝死。中华神经科学杂志,2019;9(4-5):75-80 doi: https://doi.org/10.14740/jnr553
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