Transient cerebral ischemic attack induced by transient left ventricular apical ballooning

Area of Science:

• Cardiology
• Neurology

Background:

• Transient neurological deficits can be associated with cardiac abnormalities.
• Physical stress can precipitate acute cardiovascular events.

Purpose of the Study:

• To describe a case of transient hemiplegia secondary to a reversible cardiac dysfunction.
• To investigate the underlying cardiac pathology and its resolution.

Main Methods:

• Electrocardiogram (ECG) for electrical activity assessment.
• Echocardiography for cardiac structure and function evaluation.
• Cranial computed tomography (CT) for neurological assessment.
• Coronary angiography to rule out obstructive coronary artery disease.

Main Results:

• The patient presented with transient right hemiplegia.
• ECG showed T-wave inversion and QT prolongation.
• Echocardiography revealed global left ventricular akinesia with an apical thrombus.
• Neurological imaging was unremarkable for acute events.
• Coronary angiography was normal.
• The apical thrombus resolved, and left ventricular function normalized within 3 months.

Conclusions:

• This case highlights a rare presentation of reversible left ventricular dysfunction and apical thrombus formation following physical stress.
• Prompt cardiac evaluation is crucial in patients presenting with neurological symptoms and suspected cardiac abnormalities.
• Complete recovery of cardiac function is possible in such cases.