Grewal Hardeep Kaur, Bansal Manish, Garg Arun, Kasliwal Ravi R, Bhan Anil, Gautam Dheeraj
Department of Clinical and Preventive Cardiology, Pathology and Blood Bank, Medanta-The Medicity, Gurgaon, Haryana, India.
Department of Neurology, Pathology and Blood Bank, Medanta-The Medicity, Gurgaon, Haryana, India.
Saudi J Med Med Sci. 2021 Jan-Apr;9(1):67-70. doi: 10.4103/sjmms.sjmms_525_19. Epub 2020 Dec 26.
Left ventricular (LV) thrombi usually occur in the setting of global or regional LV systolic dysfunction and are extremely rare in the absence of LV wall motion abnormalities. We report here a case of a 23-year-old female who presented with cardioembolic stroke due to ulcerative colitis. To determine the cause of stroke, several investigations and evaluations were carried out, but the results were mostly normal or unremarkable. Transthoracic echocardiography revealed an oscillating pedunculated globular mass, which was eventually resected due to recurrent transient ischemic attacks. The histopathology of the excised mass revealed it to be an organized thrombus with acute and chronic inflammatory cells and fibroblasts. The uncommon etiology combined with the unusual appearance of the thrombus presented a major diagnostic and therapeutic dilemma for this exceedingly rare cause for intracardiac thrombus formation. Therefore, it would be useful to have a low threshold for screening patients with active inflammatory bowel disease for possible ventricular thrombosis before discharge, especially if other risk factors are present.
左心室（LV）血栓通常发生在左心室整体或局部收缩功能障碍的情况下，在没有左心室壁运动异常时极为罕见。我们在此报告一例23岁女性，因溃疡性结肠炎出现心源性栓塞性中风。为确定中风原因，进行了多项检查和评估，但结果大多正常或无异常。经胸超声心动图显示一个有蒂的振荡球状肿块，由于反复短暂性脑缺血发作，最终将其切除。切除肿块的组织病理学检查显示为一个有组织的血栓，伴有急性和慢性炎症细胞及成纤维细胞。这种不常见的病因以及血栓的异常表现，给这种极其罕见的心内血栓形成原因带来了重大的诊断和治疗难题。因此，对于患有活动性炎症性肠病的患者，在出院前对可能的心室血栓形成进行筛查的阈值应较低，尤其是在存在其他危险因素的情况下，这将是有益的。
