An unusual cause of stroke--the importance of saline contrast echocardiography.
We report a case of a 38-year-old man who presented with a cryptogenic stroke in whom a persistent left superior vena cava (PLSVC) to the left atrium was established as an isolated anomaly by both echocardiography and magnetic resonance angiography. This rare cardiac abnormality creates a systemic right to left shunt and the potential for cerebral abscess or infarction. Echocardiographic diagnosis may be missed unless intravenous saline contrast is performed using a left upper extremity vein.
Tsang
Wendy
W
Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Boulos
Mark
M
Moody
Alan R
AR
Sahlas
Demetrios J
DJ
Morgan
Christopher D
CD
D000328:Adult; D003287:Contrast Media; D004452:Echocardiography / Q000379:methods*; D006325:Heart Atria / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D012965:Sodium Chloride; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology*; D014683:Vena Cava, Superior / Q000002:abnormalities* / Q000000981:diagnostic imaging*
D003287:Contrast Media; D012965:Sodium Chloride