J Cardiovasc Ultrasound.  2011 Sep;19(3):152-155. 10.4250/jcu.2011.19.3.152.

Left Ventricular Thrombus Associated with Takotsubo Cardiomyopathy: A Cardioembolic Cause of Cerebral Infarction

• Shin SN
• Yun KH
• Ko JS
• Rhee SJ
• Yoo NJ
• Kim NH
• Oh SK
• Jeong JW

• KMID: 1980371
• DOI: http://doi.org/10.4250/jcu.2011.19.3.152

Abstract

Takotsubo cardiomyopathy, also called stress-induced cardiomyopathy, usually occurs in patients with severe emotional or physiologic stress. The prognosis is favorable, and the wall motion abnormlities normalize within weeks. However, stress-induced cardiomyopathy is rarely assosicated with left ventricular thrombus and thromboembolic complications. Here, we report a case of stress-induced cardiomyopathy with left ventricular thrombus that embolized to cause cerebral infarction.

Keyword

Takotsubo cardiomyopathy; Thrombus; Cerebral infarction

MeSH Terms

Cardiomyopathies
Cerebral Infarction
Humans
Prognosis
Takotsubo Cardiomyopathy
Thrombosis

Figure

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  Fig. 1 An electrocardiogram showing an abnormal Q wave in the anterior precordial leads and a prolonged QT interval.

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  Fig. 2 Initial transthoracic echocardiographic image in the apical 4-chamber view showing left ventricular apical ballooning and dyskinesis.

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  Fig. 3 Diffusion image of magnetic resonance imaging showed multiple diffusion restrictive lesions in right cerebellar hemisphere (A), right internal capsule (B), right occipital lobe (C), and left parietal lobe (D).

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  Fig. 4 Transthoracic echocardiographic image obtained after cerebral infarction developed, shows a 24 × 25 mm thrombus (arrow) in the left ventricular apex.

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  Fig. 5 Transthoracic echocardiographic image obtained after 1 week of anticoagulation therapy shows near normal left ventricular wall motion and complete resolution of the apical thrombus.

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