Left atrial thrombus resulting in stroke

Case contributed by Stefan Tigges

Presentation

Sudden onset right upper and lower extremity weakness and slurred speech. History prior mitral valve repair and atrial fibrillation.

Patient Data

Age: 80 years
Gender: Female

Status post prior mitral valve repair, enlarged left atrium, small left pleural effusion.

Status post prior mitral valve repair, enlarged left atrium, left atrial mass.

Chronic infarction left lentiform nucleus with extension into the adjacent frontal corona radiata. Other smaller chronic infarcts are also present.

Case Discussion

The most common cause of an intracardiac mass is a thrombus. The left atrial mass was resected and proven to be a thrombus and was the presumed source of emboli that caused this patient's stroke. The mass was initially discovered on echocardiography and confirmed on CT. The patient did undergo head CT and brain MRI at presentation (not shown) which confirmed an acute ischemic stroke, shown in the chronic stage on the head CT above. 

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