Cardiac chiari network as an etiology for embolic stroke

Area of Science:

• Cardiology
• Neurology
• Medical Case Study

Background:

• The Chiari network, a congenital right atrial remnant, is rarely linked to complications.
• Embolic stroke is a significant neurological event with various potential causes.

Purpose of the Study:

• To report the first case of medically treated embolic stroke associated with a cardiac Chiari network and patent foramen ovale.
• To highlight the diagnostic utility of transesophageal echocardiography in identifying cardiac sources of stroke.

Main Methods:

• A 59-year-old woman presented with multiple cerebral infarctions.
• Transesophageal echocardiography revealed a thickened Chiari network and a right-to-left shunt.
• The patient was treated with warfarin anticoagulation.

Main Results:

• The patient experienced no new stroke events after anticoagulation.
• Repeat transesophageal echocardiography showed resolution of a presumed thrombus on the Chiari network.
• The Chiari network was identified as a potential embolic source.

Conclusions:

• Transesophageal echocardiography is essential for comprehensive right atrial evaluation in cryptogenic ischemic stroke.
• Cardiac Chiari network, though rare, should be considered in the differential diagnosis of embolic stroke.
• Medical management with anticoagulation can be effective in preventing recurrent embolic events in such cases.