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Updated: Oct 10, 2026

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Pediatric Dilated Cardiomyopathy With Suspected Hereditary Protein C/S and Antithrombin III Deficiency Presenting as
Muhammad Waleed Imran1, Muhammad Moaz1, Sanwal Sardar Nawaz1
1Shifa College of Medicine Islamabad Pakistan.
Objective:
To report a rare case of pediatric dilated cardiomyopathy (DCM) with suspected hereditary protein C, protein S, and antithrombin III deficiency presenting as ischemic stroke.
Background:
Children with DCM are at increased risk of thromboembolism. Inherited thrombophilias are an uncommon but important cause of pediatric stroke and may coexist with cardiac disease.
Case Presentation:
An 8-year-old female presented with heart failure and was diagnosed with severe DCM (LVEF ∼24%). Despite medical therapy and antiplatelet prophylaxis, she developed acute right-sided hemiparesis. MRI confirmed a left hemispheric ischemic stroke. Thrombophilia workup revealed reduced protein C (41.5%), protein S (50.7%), and antithrombin III (65.1%) levels, suggestive of a suspected inherited thrombophilic disorder, while PT/aPTT/INR remained normal. She was managed conservatively with antiplatelets and rehabilitation, showing partial neurological recovery. Follow-up demonstrated improved cardiac function (LVEF ∼50%).
Conclusion:
The coexistence of DCM and suspected inherited thrombophilia can predispose to ischemic stroke in children. Normal routine coagulation tests do not exclude thrombophilia; targeted screening should be considered in high-risk cases.
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