Ischaemic stroke, factor V Leiden heterozygosity and left atrial thrombosis in sinus rhythm: a case report.
We describe a 63-year-old man in sinus rhythm (SR) with an ischaemic stroke involving basal ganglia region on the right side. The patient was known to be heterozygous for factor V Leiden (FVL) mutation. On diagnostic work-up, no arterial sources of embolism were found. Transoesophageal echocardiography evidenced a left atrial (LA) thrombosis without relevant cardiopathies. LA thrombosis is generally associated to atrial fibrillation, atrial enlargement, mitral valve stenosis and left ventricular dysfunction, whereas mitral regurgitation is considered protective. To our knowledge, this is the first report of cardioembolic stroke related to a LA thrombosis in a patient in SR without risk factors for thrombus formation except for FVL heterozygosity.
Imperiale
D
D
Neurology Unit, Human Prion Diseases Center D.O.M.P., Maria Vittoria Hospital, Via Cibrario 72, I-10144 Torino, Italy. imperiale@asl3.to.it
Cassano
D
D
Pomari
F
F
Cecchi
E
E
Cerrato
P
P
Buffa
C
C
D001146:Arrhythmia, Sinus / Q000235:genetics* / Q000503:physiopathology; D016279:Atrial Function, Left / Q000235:genetics*; D001479:Basal Ganglia / Q000098:blood supply / Q000473:pathology; D002545:Brain Ischemia / Q000235:genetics* / Q000503:physiopathology; D004452:Echocardiography; D005165:Factor V / Q000235:genetics*; D005819:Genetic Markers; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006579:Heterozygote; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D020521:Stroke / Q000235:genetics* / Q000503:physiopathology; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000235:genetics* / Q000503:physiopathology
D005819:Genetic Markers; C095381:factor V Leiden; D005165:Factor V