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Embolic stroke in a child with idiopathic dilated cardiomyopathy
S C Karande1, S G Kulthe, K R Lahiri
1Department of Pediatrics, Seth GS Medical College, Parel, Mumbai.
Insights
A young boy with idiopathic dilated cardiomyopathy experienced stroke symptoms due to intracardiac clots. Anticoagulation dissolved most clots, but cardiac failure led to his death.
Area of Science:
- Pediatric Neurology
- Cardiology
Background:
- Idiopathic dilated cardiomyopathy is a serious heart condition.
- Intracardiac thrombi can lead to embolic events.
Observation:
- An 11-year-old boy presented with acute hemiplegia and facial weakness.
- Echocardiography identified idiopathic dilated cardiomyopathy with multiple intracardiac clots.
- Cranial MRI revealed infarcts in the basal ganglia, brainstem, and cerebellum.
Findings:
- Anticoagulation therapy successfully resolved most intracardiac thrombi.
- The patient ultimately succumbed to resistant cardiac failure 2.5 months later.
Implications:
- This case highlights the risk of embolic stroke in pediatric cardiomyopathy.
- Effective anticoagulation may reduce thromboembolic complications.
- Cardiomyopathy-related cardiac failure remains a significant mortality risk in children.
Abstract:
An eleven year old boy presented with sudden onset right-sided hemiplegia and ipsilateral lower facial weakness. Two-dimensional echo revealed the diagnosis of idiopathic dilated cardiomyopathy with multiple intracardiac clots. MRI scan of head showed infarctions in the area of caudate nuclei, putamen, brain stem and cerebellum. On anticoagulation therapy, all thrombi, except one, disappeared. The child died 2.5 months later due to resistant cardiac failure.