Hyperhomocysteinemia can present with myriad severe cardiovascular manifestations, including the simultaneous occurrence of layered left ventricular thrombus and spontaneous coronary artery dissection.
Supports conservative management in hyperhomocysteinemia with concurrent LV thrombus and SCAD; leaves open prospective trials on targeted therapy.
Homocysteine has been recognized as a risk factor for various cardiovascular manifestations including thrombosis of arterial and venous system, spontaneous dissection involving various vessels in the body including coronaries and aneurysms. Here we report a young gentleman who was diagnosed as stroke in young and found to have dilated cardiomyopathy, with left ventricular dysfunction and hyperhomocysteinemia. Now the patient was presenting with unstable angina and found to have layered left ventricular thrombus on echocardiography and spontaneous coronary artery dissection on angiography. Our patient is being followed up on optimal medical management, as he is asymptomatic with medications.
No takes yet. Share an insight, caveat, or question.
Babu et al. (2015) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: