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Chorea after cardiac surgery.

Petr Hollý1,2, Petr Dušek3,4, Petra Reková3

  • 1Department of Neurology, Charles University, 1st Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic petr.holly@vfn.cz.

Practical Neurology
|August 14, 2025
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Summary

Chorea after cardiac surgery is rare in adults but can occur. This case study details a 47-year-old woman who developed chorea post-cardiac surgery, with symptoms improving after haloperidol treatment.

Keywords:
ARTERIAL DISSECTIONCEREBRAL BLOOD FLOWCOLLAGENDYSTONIAMOVEMENT DISORDERS

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Area of Science:

  • Neurology
  • Cardiology
  • Medical Case Study

Background:

  • Chorea after cardiac surgery, previously termed post-pump chorea, is a recognized complication, predominantly affecting children.
  • While infrequent in adults, chorea post-cardiac surgery in this demographic is often persistent and challenging to manage.
  • This condition involves involuntary, irregular, and jerky movements affecting the limbs and face.

Purpose of the Study:

  • To report a rare case of adult-onset chorea following complex cardiac surgery.
  • To illustrate the clinical presentation, diagnostic findings, and treatment response in an adult patient with post-cardiac surgery chorea.
  • To contribute to understanding the management of this uncommon neurological complication.

Main Methods:

  • A 47-year-old female patient underwent cardiac surgery for pseudoaneurysm repair and prosthetic aortic valve thrombectomy.
  • Post-operatively, the patient developed chorea affecting all four limbs.
  • Magnetic Resonance (MR) imaging of the brain was performed, revealing bilateral basal ganglia abnormalities.

Main Results:

  • The patient exhibited significant choreiform movements post-cardiac surgery.
  • Brain MR scans demonstrated bilateral basal ganglia abnormalities, which showed partial resolution over a three-month period.
  • Despite initial therapeutic interventions, the patient's condition deteriorated until the initiation of haloperidol treatment.

Conclusions:

  • Chorea can manifest as a rare but severe complication in adults after cardiac surgery.
  • Haloperidol demonstrated efficacy in managing chorea symptoms in this adult patient, suggesting its potential role in treatment.
  • This case underscores the importance of considering and managing chorea in adult patients presenting with neurological deficits post-cardiac procedures.