Identification of an Intracardiac Shunt in a Patient With Recurrent Cryptogenic Strokes: Are Dextrose Solutions More Sensitive?
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ABSTRACT:
SUBMITTER: Fuller M
PROVIDER: S-EPMC8071824 | biostudies-literature | 2021 Apr
REPOSITORIES: biostudies-literature
Publications
Identification of an Intracardiac Shunt in a Patient With Recurrent Cryptogenic Strokes: Are Dextrose Solutions More Sensitive?
Fuller Max M Buda Kevin G KG Urbach Jonathan J Carlson Michelle D MD Herzog Charles A CA
CASE (Philadelphia, Pa.) 20210107 2
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Project description:BackgroundHaving an inter-atrial shunt in the form of a patent foramen ovale or atrial septal defect increases the risk of developing cryptogenic stroke. Prompt action is required in order to prevent stroke recurrence. The source of embolization may not be clear on stroke workup.Case presentationA young female acutely presented with recurrent embolizations to the eye and brain. She was found to have an atrial septal defect. No clear intra-cardiac source of embolization was detected on workup including trans-esophageal echocardiography. Given the options between surgical versus device closure, the attending team opted for the surgical closure which yielded on direct left heart inspection small organized clots adherent to the tips of the mitral valve leaflets.ConclusionsThe case report illustrates the potential advantages of the direct surgical closure in detecting and extracting the embolization source in patients who present with recurrent cryptogenic stroke.
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