AccScience Publishing / BH / Volume 1 / Issue 2 / DOI: 10.36922/bh.1115
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CASE REPORT

Pedunculated left endoventricular thrombosis complicated by cerebral stroke in patient with suspected peripartum cardiomyopathy: A case report

Kristian Galanti1† Roberta Magnano2† Laura Pezzi2† Mario Di Marino1† Alberto D’ Alleva2 Daniele Forlani2 Piergiusto Vitulli2 Vincenzo Di Egidio3 Gabriele Di Giammarco4 Leonardo Paloscia2 Sabina Gallina1 Massimo Di Marco2†*
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1 Department of Neuroscience, Imaging and Clinical Sciences, G. D’Annunzio University of Chieti-Pescara, 66100, Chieti, Italy
2 Department of Cardiology and ICCU, Santo Spirito Hospital, Pescara, 65124, Italy
3 Department of Radiology, Santo Spirito Hospital, Pescara, 65124, Italy
4 Department of Cardiac Surgery, G. D’Annunzio University of Chieti-Pescara, Chieti, 66100, Italy
Brain & Heart 2023, 1(2), 1115 https://doi.org/10.36922/bh.1115
Submitted: 21 June 2023 | Accepted: 12 October 2023 | Published: 3 November 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Peripartum cardiomyopathy (PPMC) is an infrequent form of cardiomyopathy, whose main presentation is characterized by systolic dysfunction that commonly emerges in the early postpartum period. Acute heart failure symptoms such as congestion and dyspnea are common manifestations of PPMC. Here, we present a case of a 32-year-old female who, after hospitalization, manifested dyspnea and thoracic pain linked to the findings a left endoventricular thrombus. After the admission to the intensive cardiovascular care unit, heart failure and anticoagulant therapies as well as non-steroidal anti-inflammatory drugs were administered, leading to initial improvement of the left ventricular global function. Five days after the treatment, the patient experienced aphasia and right hemiplegia. The cerebral angiography documented an M1 segment occlusion. After treating the occlusion with stent retriever thrombectomy, the symptoms regressed and she attained full recovery. Therefore, surgical thrombectomy should be prioritized as the treatment approach to removing the pedunculated left ventricular thrombus, considering the apical morphology of the pedunculated left ventricular thrombus and if the anticoagulant therapy gives rise to side effects.

Keywords
Peripartum cardiomyopathy
Apical thrombus
Stroke
Stent retriever thrombectomy
Surgical thrombectomy
Funding
None.
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Conflict of interest
The authors declare that they have no competing interests.
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Brain & Heart, Electronic ISSN: 2972-4139 Published by AccScience Publishing