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Lambl's Excrescences Associated with Cardioembolic Stroke
Biraj Shrestha1, Arpan Pokhrel1, Ibiyemi Oke1
1Department of Medicine, Reading Hospital - Tower Health, West Reading, PA, USA.
The American Journal of Case Reports
|March 22, 2022
Summary
Lambl's excrescences, rare valve abnormalities, can cause embolic stroke. This case highlights their potential role in stroke, suggesting conservative antiplatelet therapy for initial events.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Lambl's excrescences (LE) are threadlike fronds on heart valve closure lines.
- They can lead to thrombus formation, potentially causing embolic events like stroke or coronary obstruction.
Observation:
- A 73-year-old man presented with visual disturbance, diagnosed as an embolic stroke in the right posterior cerebral artery territory.
- Echocardiography revealed echo density on the left coronary cusp, suggestive of Lambl's excrescences.
Findings:
- The patient's stroke was attributed to embolization from Lambl's excrescences.
- No significant arrhythmia was detected on his implantable loop recorder.
Implications:
- Lambl's excrescences should be considered in the differential diagnosis of embolic stroke.
- Conservative management with antiplatelet therapy is suggested for first-time stroke episodes due to LE.
- Anticoagulation and surgical consideration are recommended for recurrent ischemic events.
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