Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Case Report
Left Ventricular Apical Thrombus Formation in a Patient With Suspected Tako-Tsubo-Like Left Ventricular Dysfunction
Satoshi KurisuIchiro InoueTakuji KawagoeMasaharu IshiharaYuji ShimataniKenji NishiokaTakashi UmemuraSuji NakamuraMasashi YoshidaHikaru Sato
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2003 Volume 67 Issue 6 Pages 556-558

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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 4×4-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'. (Circ J 2003; 67: 556 - 558)

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© 2003 THE JAPANESE CIRCULATION SOCIETY
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