Subject(s)
Coronary Aneurysm/etiology , Coronary Vessels/diagnostic imaging , Forecasting , Mucocutaneous Lymph Node Syndrome/complications , Adolescent , Coronary Aneurysm/diagnosis , Coronary Angiography , Disease Progression , Echocardiography , Humans , Male , Mucocutaneous Lymph Node Syndrome/diagnosisABSTRACT
Paradoxical embolism is considered the major cause of cerebral ischemic events in young patients. The most common cause of paradoxical embolism, which has been widely described, is right-to-left shunting (RLS) at cardiac level through a patent foramen ovale (PFO). Rarely paradoxical embolism can also be caused by RLS at pulmonary level due to pulmonary arteriovenous fistula (PAVF). Herein, we present a case of a young man, who experienced transient ischemic attack (TIA) due to paradoxical embolism, in whom both abovementioned abnormalities coexisted. This coincidence is very rare (noted in only 1% of patients with cryptogenic stroke or TIA), but it highlights the importance of searching for extracardiac RLS in patients with cryptogenic stroke, even if a PFO has been detected.
