Korean Circ J.  2001 Sep;31(9):945-948. 10.4070/kcj.2001.31.9.945.

A Case of Cerebral Thromboembolism Occurred after Restoration to Sinus Rhythm of Paroxysmal Atrial Flutter in Apical Hypertropic Cardiomyopathy with Spontaneous Echo Contrast(SEC)

• Choi KH
• Lim SW
• Choi JH
• Ok JW
• Hwang KH
• Kim TY
• Cho YK
• Hwang JH
• Cha DH

• KMID: 2227298
• DOI: http://doi.org/10.4070/kcj.2001.31.9.945

Abstract

Atrial flutter occurs most often in patients with organic heart disease. It appears that chronic atrial flutter is associated with a remarkably high risk of clinically apparent thromboembolism and effective anticoagulation appears to reduce this risk, but acute or recent onset, postoperative atrial flutter may have a lower risk of thromboembolism than those with chronic atrial flutter. In chronic atrial flutter or fibrillation with organic heart disease, anticoagulation is generally justified but there is some debate about anticoagulation in paroxysmal atrial flutter. The spontaneous echo contrast is generally accepted one of the major risk factor of thromboembolism and usually occurred in mitral stenosis, dilated cardiomyopathy, and enlarged left atrium, but rarely observed in apical hypertrophic cardiomyopathy. We experienced a patient with apical hypertrophic cardiomyopathy, who visited to emergency medical center due to dizziness and suffered from cerebral thromboembolism after restoration of sinus rhythm. In transesophageal echocardiography, there was moderate to severe spontaneous echo contrast in left atrium. This patient showed that transesophageal echocardiography evaluation of left atrium might be mandatory in patients with paroxysmal atrial flutter and organic heart disease.

Keyword

Atrial flutter; Apical hypertrophic cardiomyopathy; Spontaneous echo contrast

MeSH Terms

Atrial Flutter*
Cardiomyopathies*
Cardiomyopathy, Dilated
Cardiomyopathy, Hypertrophic
Dizziness
Echocardiography, Transesophageal
Emergencies
Heart Atria
Heart Diseases
Humans
Mitral Valve Stenosis
Risk Factors
Thromboembolism*