Why the study?
Left ventricular thrombi are extremely rare in the absence of LV wall motion abnormalities, and their occurrence in patients with ulcerative colitis causing cardioembolic stroke is not well characterized.
Case Report (n=1)
Active inflammatory bowel disease can be a rare cause of intracardiac thrombus formation and cardioembolic stroke even in the absence of left ventricular wall motion abnormalities.
Answers are grounded in this paper and cite their sources.
May alert clinicians to rare intracardiac thrombus risk in active inflammatory bowel disease without wall motion abnormalities; leaves open need for prospective confirmation.
Left ventricular (LV) thrombi usually occur in the setting of global or regional LV systolic dysfunction and are extremely rare in the absence of LV wall motion abnormalities. We report here a case of a 23-year-old female who presented with cardioembolic stroke due to ulcerative colitis. To determine the cause of stroke, several investigations and evaluations were carried out, but the results were mostly normal or unremarkable. Transthoracic echocardiography revealed an oscillating pedunculated globular mass, which was eventually resected due to recurrent transient ischemic attacks. The histopathology of the excised mass revealed it to be an organized thrombus with acute and chronic inflammatory cells and fibroblasts. The uncommon etiology combined with the unusual appearance of the thrombus presented a major diagnostic and therapeutic dilemma for this exceedingly rare cause for intracardiac thrombus formation. Therefore, it would be useful to have a low threshold for screening patients with active inflammatory bowel disease for possible ventricular thrombosis before discharge, especially if other risk factors are present.
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Grewal et al. (2020) conducted a case report in Left ventricular thrombus and cardioembolic stroke in ulcerative colitis (n=1). Surgical resection of left ventricular mass was evaluated on Histopathology of the excised mass.
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