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Cardiomiopatía auricular como posible fuente embólica en la oclusión de grandes vasos
Takuya Moriyama1, Shuhei Okazaki2, Haruhiko Abe3
1Department of Neurology, NHO Osaka National Hospital, Osaka, Japan.
BMJ case reports
|January 7, 2026
Resumen
Este caso destaca cómo la miocardiopatía auricular, incluso sin fibrilación auricular (FA) persistente, puede causar un accidente cerebrovascular embólico. Sugiere que las anomalías cardíacas son un mecanismo independiente de accidente cerebrovascular.
Área de la Ciencia:
- Cardiología
- Neurología
- Patología
Sus antecedentes:
- El accidente cerebrovascular embólico a menudo resulta de la fibrilación auricular (FA).
- Las anomalías cardíacas subclínicas también pueden precipitar eventos embólicos.
- La miocardiopatía auricular se reconoce cada vez más como una etiología de accidente cerebrovascular.
Objetivo del estudio:
- Presentar un caso de accidente cerebrovascular embólico relacionado con miocardiopatía auricular.
- Investigar los mecanismos del accidente cerebrovascular en ausencia de FA sostenida.
- Apoyar la miocardiopatía auricular como una vía independiente de accidente cerebrovascular.
Principales métodos:
- Informe de caso de un hombre de edad avanzada con hemiparesia y oclusión de la arteria carótida.
- Se realizó trombectomía mecánica con éxito.
- Se analizaron la monitorización cardíaca (grabador de bucle implantable) y los hallazgos de la autopsia.
Principales resultados:
- El paciente experimentó un episodio transitorio de fibrilación auricular (FA) durante la hospitalización.
- La autopsia reveló fibrosis auricular izquierda y depósitos de amiloide, indicativos de miocardiopatía auricular.
- No se identificaron otras fuentes embólicas a pesar de una evaluación exhaustiva.
Conclusiones:
- La miocardiopatía auricular leve o subclínica puede ser una causa de accidente cerebrovascular embólico.
- La miocardiopatía auricular puede actuar como un mecanismo independiente de accidente cerebrovascular, incluso sin FA manifiesta.
- Este caso subraya la importancia de evaluar la estructura cardíaca en el accidente cerebrovascular criptogénico.
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