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Acute left ventricular dysfunction and left ventricular thrombus in a patient with cerebral hemorrhage
I Misumi1, Y Kimura, Y Hokamura
1Department of Cardiology, Kumamoto City Hospital.
Insights
A cerebral hemorrhage triggered severe cardiac dysfunction, including left ventricular hypokinesis and thrombus formation. These cardiac issues resolved spontaneously within one month, indicating a non-ischemic cause.
Area of Science:
- Cardiology
- Neurology
Background:
- Cerebral hemorrhage can precipitate secondary systemic complications.
- Left ventricular dysfunction and thrombus formation are serious cardiac events.
Observation:
- A 66-year-old female presented with cerebral hemorrhage.
- Initial echocardiogram revealed severe left ventricular hypokinesis and a left ventricular thrombus.
- Electrocardiogram showed ST segment elevation, and creatine kinase levels were elevated.
Findings:
- Follow-up echocardiogram demonstrated normalization of left ventricular function and thrombus resolution.
- Coronary arteriography and ventriculography were normal.
- The cardiac dysfunction was attributed to massive adrenergic discharge secondary to cerebral hemorrhage, not myocardial infarction or myocarditis.
Implications:
- This case highlights the potential for significant cardiac manifestations secondary to neurological events.
- Massive adrenergic discharge can mimic acute coronary syndromes.
- Understanding this link is crucial for accurate diagnosis and management of patients with concurrent neurological and cardiac issues.
Abstract:
A 66-year-old woman was admitted to the hospital with a cerebral hemorrhage. An echocardiogram showed severe left ventricular hypokinesis and a left ventricular thrombus. An electrocardiogram showed ST segment elevation in the precordial leads. The patient's creatine kinase level was elevated. A follow-up echocardiogram performed 1 month after admission showed normalization of left ventricular wall motion and disappearance of the thrombus. The results of thallium myocardial scintigraphy, coronary arteriography, and left ventriculography performed 1 month after admission were normal, and the patient was discharged without clinical sequelae. The cause of the patient's left ventricular dysfunction was believed to be not myocardial infarction or myocarditis, but a massive adrenergic discharge due to the cerebral hemorrhage.