Korean Circ J.  2013 Mar;43(3):204-206. 10.4070/kcj.2013.43.3.204.

A Case of Myopathy, Encephalopathy, Lactic Acidosis and Stroke-Like Episodes (MEALS) Syndrome with Intracardiac Thrombus

• Joo JC
• Seol MD
• Yoon JW
• Lee YS
• Kim DK
• Choi YH
• Ahn HS
• Cho WH

• KMID: 2224968
• DOI: http://doi.org/10.4070/kcj.2013.43.3.204

Abstract

Myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) is a multisystem clinical syndrome manifested by mitochondrial myopathy, encephalopathy, lactic acidosis and recurrent stroke-like episodes. A 27-year-old female with MELAS syndrome presented with cerebral infarction. Echocardiography revealed a thrombus attached to the apex of the hypertrophied left ventricle, with decreased systolic function. The embolism of the intracardiac thrombus might have been the cause of stroke. There should be more consideration given to the increased possibility of intracardiac thrombus formation when a MELAS patient with cardiac involvement is encountered.

Keyword

MELAS syndrome; Heart; Thrombosis

MeSH Terms

Acidosis, Lactic
Cerebral Infarction
Echocardiography
Embolism
Female
Heart
Heart Ventricles
Humans
MELAS Syndrome
Mitochondrial Myopathies
Muscular Diseases
Stroke
Thrombosis

Figure

• 

  Fig. 1 Brain diffusion-weighted magnetic resonance imaging shows restricted diffusion (arrow) involving right front-temporal lobe, right insula and right basal ganglia, which indicates the acute infarction in the right middle cerebral artery territory.

• 

  Fig. 2 Magnetic resonance angiography shows non-visible flow at right distal internal carotid artery (right arrow) and right middle cerebral artery (down arrow).

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  Fig. 3 Echocardiography detected a mobile small thrombus (arrow) with length of 2.2 cm attached to left ventricular apex at short axis view (A) and two chamber view (B).

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