A Change of Heart: Yield of Cardiac Imaging in Acute Stroke Workup

Frans Kauw; Jan W. Dankbaar; Jesse Habets; Maarten J.M. Cramer; Hugo W.A.M. de Jong; Birgitta K. Velthuis; L. Jaap Kappelle

doi:10.1159/000489254

A Change of Heart: Yield of Cardiac Imaging in Acute Stroke Workup

Frans Kauw^*
, Jan W. Dankbaar
, Jesse Habets
, Maarten J.M. Cramer
, Hugo W.A.M. de Jong
, Birgitta K. Velthuis
, L. Jaap Kappelle

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

This case report describes a patient who experienced a recurrent ischemic stroke within 24 h. Dual-energy computed tomography (DECT) angiography on admission showed 2 intracardiac thrombi, 1 in the left ventricle and 1 in the left atrial appendage. Following the second ischemic event, repeated DECT angiography showed that the ventricular thrombus had considerably diminished, suggesting that the recurrent brain infarction was caused by cardioembolism. This case emphasizes (1) the potential benefit of cardiac evaluation through CT angiography in the acute stroke setting, and (2) the use of DECT angiography for the detection of thrombus and the differentiation between thrombus, the myocardial wall, and a slow flow of contrast.

Original language	English
Pages (from-to)	118-123
Number of pages	6
Journal	Case Reports in Neurology
Volume	10
Issue number	2
DOIs	https://doi.org/10.1159/000489254
Publication status	Published - 1 May 2018

Keywords

Acute stroke imaging
Cardioembolic stroke
Computed tomography angiography
Dual-energy computed tomography
Ischemic stroke
Recurrent stroke

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title = "A Change of Heart: Yield of Cardiac Imaging in Acute Stroke Workup",

abstract = "This case report describes a patient who experienced a recurrent ischemic stroke within 24 h. Dual-energy computed tomography (DECT) angiography on admission showed 2 intracardiac thrombi, 1 in the left ventricle and 1 in the left atrial appendage. Following the second ischemic event, repeated DECT angiography showed that the ventricular thrombus had considerably diminished, suggesting that the recurrent brain infarction was caused by cardioembolism. This case emphasizes (1) the potential benefit of cardiac evaluation through CT angiography in the acute stroke setting, and (2) the use of DECT angiography for the detection of thrombus and the differentiation between thrombus, the myocardial wall, and a slow flow of contrast.",

keywords = "Acute stroke imaging, Cardioembolic stroke, Computed tomography angiography, Dual-energy computed tomography, Ischemic stroke, Recurrent stroke",

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doi = "10.1159/000489254",

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T2 - Yield of Cardiac Imaging in Acute Stroke Workup

AU - Kauw, Frans

AU - Dankbaar, Jan W.

AU - Habets, Jesse

AU - Cramer, Maarten J.M.

AU - de Jong, Hugo W.A.M.

AU - Velthuis, Birgitta K.

AU - Kappelle, L. Jaap

PY - 2018/5/1

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N2 - This case report describes a patient who experienced a recurrent ischemic stroke within 24 h. Dual-energy computed tomography (DECT) angiography on admission showed 2 intracardiac thrombi, 1 in the left ventricle and 1 in the left atrial appendage. Following the second ischemic event, repeated DECT angiography showed that the ventricular thrombus had considerably diminished, suggesting that the recurrent brain infarction was caused by cardioembolism. This case emphasizes (1) the potential benefit of cardiac evaluation through CT angiography in the acute stroke setting, and (2) the use of DECT angiography for the detection of thrombus and the differentiation between thrombus, the myocardial wall, and a slow flow of contrast.

AB - This case report describes a patient who experienced a recurrent ischemic stroke within 24 h. Dual-energy computed tomography (DECT) angiography on admission showed 2 intracardiac thrombi, 1 in the left ventricle and 1 in the left atrial appendage. Following the second ischemic event, repeated DECT angiography showed that the ventricular thrombus had considerably diminished, suggesting that the recurrent brain infarction was caused by cardioembolism. This case emphasizes (1) the potential benefit of cardiac evaluation through CT angiography in the acute stroke setting, and (2) the use of DECT angiography for the detection of thrombus and the differentiation between thrombus, the myocardial wall, and a slow flow of contrast.

KW - Acute stroke imaging

KW - Cardioembolic stroke

KW - Computed tomography angiography

KW - Dual-energy computed tomography

KW - Ischemic stroke

KW - Recurrent stroke

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A Change of Heart: Yield of Cardiac Imaging in Acute Stroke Workup

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