Dual potential embolic source detected in left atrium during hyperacute stroke

Clinical introduction A woman in her late 60s with a medical history of hypertension presented to the emergency department with symptoms of a stroke which began 40 min prior. Brain MRI was performed (figure 1A). Hyperacute CT angiography of the head and neck did not find any atherosclerosis. ECG is shown (figure 1B), and subsequent transthoracic echocardiography showed left atrium enlargement and left-to-right flow at the region of the fossa ovalis (figure 1C). Figure 1Brain MRI of diffusion-weighted image sequence (A), ECG (B), and transthoracic echocardiogram (C). Question Which of the following is the most likely mechanism of this patient’s embolic stroke? Paradoxical embolism through patent foramen ovale Embolism due to atrial fibrillation (AF) Embolism due to cerebrovascular atherosclerosis Embolic stroke of undetermined source Answer: B Both patent foramen...

Source: Heart - September 13, 2023 Category: Cardiology Authors: Fu, Z., Xu, C., Gao, L. Tags: Image challenges Source Type: research