Hakobyan Narek, Ilerhunmwuwa Nosakhare, Wasifuddin Mustafa, Jamal Fares, Zagoruychenko Tatyana
Internal Medicine, Brookdale University Hospital Medical Center, New York City, USA.
Cureus. 2023 Jun 24;15(6):e40910. doi: 10.7759/cureus.40910. eCollection 2023 Jun.
Lambl's excrescences (LEs) are delicate filiform strands formed by connective tissue located along the valve closure lines within the cardiovascular system. Most cases of these excrescences manifest without discernible symptoms, and the exact etiological factors contributing to their formation remain unknown. These excrescences may embolize to the brain, causing strokes. It is essential that all other possible causes of stroke be eliminated prior to identifying Lambl's excrescences as the cause of the stroke. Herein, we present a case of a patient who suffered a stroke, and all conventional testing for common causes of embolic strokes was ruled out. In pursuit of a comprehensive evaluation encompassing the classification of the stroke as cryptogenic, a transesophageal echocardiogram (TEE) was performed, which effectively disclosed the existence of LEs situated on the aortic valve leaflets. The patient was treated with anticoagulation and discharged with close follow-up monitoring. To culminate, the inclusion of this case within our study augments the currently scarce pool of instances that exhibit such characteristic cardioembolic phenomena, thereby accentuating the necessity for additional prospective investigations to substantiate the existence of a causative association linking LEs and cardioembolic strokes.
兰布尔赘生物（LEs）是由位于心血管系统内瓣膜闭合线上的结缔组织形成的纤细丝状条索。这些赘生物的大多数病例并无明显症状，其形成的确切病因尚不清楚。这些赘生物可能会栓塞至脑部，导致中风。在将兰布尔赘生物确定为中风病因之前，必须排除所有其他可能导致中风的原因。在此，我们报告一例中风患者，所有针对栓塞性中风常见病因的常规检查均排除。为了对该中风进行全面评估并将其归类为隐源性中风，进行了经食管超声心动图（TEE）检查，结果有效显示主动脉瓣叶上存在兰布尔赘生物。该患者接受了抗凝治疗，并在密切随访监测下出院。最后，将该病例纳入我们的研究增加了目前此类具有特征性心脏栓塞现象病例的稀缺样本库，从而突出了进行更多前瞻性研究以证实兰布尔赘生物与心脏栓塞性中风之间存在因果关联的必要性。
