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Cor triatriatum and stroke

Jose Danilo Bengzon Diestro1, Joseph Justin Hipolito Regaldo2, Eddieson Masangcay Gonzales2

  • 1Department of Neurosciences, Philippine General Hospital, University of the Philippines, Manila, Philippines.

BMJ Case Reports
|August 10, 2017
PubMed

Insights

Cor triatriatum sinistrum (CTS) is a rare congenital heart defect causing stroke. This case highlights treatment failures with antiplatelet and anticoagulant therapies in a young patient.

Area of Science:

  • Cardiology
  • Neurology
  • Congenital Heart Disease

Background:

  • Cor triatriatum sinistrum (CTS) is a rare congenital cardiac anomaly characterized by a fibromuscular membrane dividing the left atrium.
  • CTS can lead to significant neurological complications, including stroke.

Observation:

  • A 19-year-old female presented with a right middle cerebral artery (MCA) territory infarct.
  • Diagnosis of CTS was confirmed via transthoracic echocardiography (TTE) showing a dividing membrane.
  • The patient experienced recurrent strokes despite aspirin and later apixaban therapy.

Findings:

  • This case represents the longest follow-up of a patient with CTS and stroke.
  • It is the first reported instance of failure of both antiplatelet and anticoagulant therapies in managing CTS-related neurological events.
  • The patient ultimately succumbed to hospital-acquired pneumonia following a third stroke.

Implications:

  • This case underscores the potential for severe neurological morbidity in CTS.
  • It challenges current treatment paradigms, suggesting limitations of standard antiplatelet and anticoagulant strategies in select CTS patients.
  • Further research into optimal management of CTS to prevent thromboembolic events is warranted.

Keywords:
Cardiovascular MedicineNeurologyStroke

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