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Two cases of cerebral embolism caused by apical thrombi in midventricular obstructive cardiomyopathy

Ikuko Takeda1, Mayu Sekine, Hayato Matsushima

  • 1Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical Sciences, Japan. itakeda@hiroshima-u.ac.jp

Internal Medicine (Tokyo, Japan)
|May 3, 2011
PubMed

Insights

Midventricular obstructive hypertrophic cardiomyopathy (MOHC) can cause embolic stroke. This occurs due to apical aneurysms, which form from turbulent blood flow, leading to blood clots and subsequent stroke, even without atrial fibrillation.

Area of Science:

  • Cardiology
  • Neurology
  • Pathology

Background:

  • Midventricular obstructive hypertrophic cardiomyopathy (MOHC) is a rare cardiac condition.
  • Cardiomyopathies can lead to systemic complications, including stroke.

Observation:

  • Two patients with MOHC experienced embolic strokes.
  • The source of emboli was identified as thrombi within apical aneurysms.

Findings:

  • Apical aneurysms in MOHC result from turbulent blood flow and myocardial endocardial injury.
  • These aneurysms serve as a nidus for thrombus formation, leading to embolization.
  • Embolic stroke can occur in MOHC patients with apical aneurysms, independent of atrial fibrillation.

Implications:

  • Highlights a novel mechanism for stroke in hypertrophic cardiomyopathy.
  • Suggests the need for vigilance regarding apical aneurysms in MOHC patients.
  • May inform stroke risk stratification and preventative strategies in specific cardiomyopathy populations.

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