Edwards P, Wozniak M, Corretti M, Price T R
From the Department of Neurology, Division of Cardiology, University of Maryland Medical Center, Baltimore, MD, U.S.A.
The Department of Medicine, Division of Cardiology, University of Maryland Medical Center, Baltimore, MD, U.S.A.
J Stroke Cerebrovasc Dis. 1994;4(4):238-41. doi: 10.1016/S1052-3057(10)80098-9. Epub 2010 Jun 9.
The Chiari network is a congenital remnant in the right atrium. It is not commonly associated wtih clinical complications. We report the first case of medically treated embolic stroke in a patient with a cardiac Chiari network and a patent foramen ovale. A 59-year-old woman without cardiac history or signs presented with multiple cerebral infarctions in both the anterior and posterior cerebral circulations. Standard evaluation for cerebral infarction was unrevealing. Transesophageal echocardiography demonstrated a Chiari network in the right atrium and a right-to-left shunt. The Chiari network appeared thickened. After anticoagulation with warfarin, the patient developed no new symptoms of stroke, and repeat transesophageal echocardiography showed resolution of the presumed thrombus on the Chiari network. In workup of patients with ischemic strokes of unknown etiology, transesophageal echocardiography should be considered as an important method for comprehensive evaluation of the right atrium.
奇亚里网是右心房的先天性残余物。它通常与临床并发症无关。我们报告了首例患有心脏奇亚里网和卵圆孔未闭的患者经药物治疗的栓塞性中风。一名无心脏病史或体征的59岁女性出现大脑前循环和后循环多发脑梗死。脑梗死的标准评估未发现异常。经食管超声心动图显示右心房有奇亚里网和右向左分流。奇亚里网看起来增厚。使用华法林抗凝后，患者未出现新的中风症状，重复经食管超声心动图显示奇亚里网上的推测血栓已溶解。在对病因不明的缺血性中风患者进行检查时，应考虑将经食管超声心动图作为全面评估右心房的重要方法。
