ABSTRACT
BACKGROUND AND AIM: Oral anticoagulation (AC) and percutaneous left atrial appendage (LAA) occlusion are the primary treatment modalities for stroke prevention in atrial fibrillation (AF), but there remains a subset of patients in whom these approaches present excess risk and isolated surgical LAA excision should be considered. We describe a 63-year-old female with AF and recurrent thromboembolic events who presented with an acute intraparenchymal hemorrhage and was found to have an intracardiac thrombus. METHODS: Given contraindications to AC and LAA occlusion, an isolated LAA surgical excision was pursued. RESULTS: She underwent successful surgical LAA excision and has since remained event-free. CONCLUSION: It is important to recall the utility of therapies that have been previously used with success for intracardiac thrombi and still remain as viable options.
Subject(s)
Atrial Appendage/surgery , Atrial Fibrillation/surgery , Cardiac Surgical Procedures/methods , Administration, Oral , Anticoagulants/adverse effects , Atrial Fibrillation/complications , Cerebral Hemorrhage/etiology , Contraindications , Female , Heart Diseases/etiology , Humans , Male , Middle Aged , Recurrence , Risk , Stroke/etiology , Stroke/prevention & control , Thrombosis/etiology , Treatment OutcomeABSTRACT
We describe the case of a 68-year-old woman presenting with stress cardiomyopathy (SCM), with concomitant cardiogenic shock, left ventricular outflow tract obstruction, and ventricular septal rupture. These complications have not simultaneously been reported in a single SCM case. The importance of early diagnosis of serial complications of SCM and using mechanical circulatory support as a treatment strategy are highlighted.
