title: Left ventricular apical thrombus formation in a patient with suspected tako-tsubo-like left ventricular dysfunction.
abstract: A 74-year-old woman with hypertension and bronchial asthma had chest discomfort at rest and 4 days later was admitted to her nearby hospital because of the sudden onset of right hemiparesis. The hemiparesis had almost disappeared within 24 h of onset, but because an electrocardiogram showed sinus tachycardia and diffuse symmetrical T-wave inversion, she was referred for cardiac examination. Coronary angiography did not reveal any significant coronary artery stenosis, but left ventriculography revealed severe hypokinesis of the left ventricular apical region, which contained a 4 x 4-mm solid thrombus moving freely with a wavy motion. Moreover, the activity of both protein C and protein S had decreased. The thrombus disappeared after 2 weeks of anticoagulant treatment with warfarin. Her clinical course suggested that the transient cerebral ischemic attack was caused by embolism of the left ventricular thrombus associated with 'tako-tsubo-like left ventricular dysfunction'.
authors.affiliation: Division of Cardiology, Hiroshima City Hospital, Japan. skurisu@nifty.com
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kurisu
authors.forename: Ichiro
authors.initials: I
authors.lastname: Inoue
authors.forename: Takuji
authors.initials: T
authors.lastname: Kawagoe
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimatani
authors.forename: Kenji
authors.initials: K
authors.lastname: Nishioka
authors.forename: Takashi
authors.initials: T
authors.lastname: Umemura
authors.forename: Suji
authors.initials: S
authors.lastname: Nakamura
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoshida
authors.forename: Hikaru
authors.initials: H
authors.lastname: Sato
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D006331:Heart Diseases / Q000209:etiology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology; D011859:Radiography; D013577:Syndrome; D013927:Thrombosis / Q000209:etiology*; D018487:Ventricular Dysfunction, Left / Q000145:classification / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin