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Rare disease
CASE REPORT
Cor triatriatum and stroke
  1. Jose Danilo Bengzon Diestro1,
  2. Joseph Justin Hipolito Regaldo2,
  3. Eddieson Masangcay Gonzales2,
  4. Maria Kristina Casanova Dorotan3,
  5. Adrian Isidoro Espiritu1,
  6. Jose Leonard Rivera Pascual V1,4
  1. 1Department of Neurosciences, Philippine General Hospital, University of the Philippines, Manila, Philippines
  2. 2Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
  3. 3Department of Neurology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
  4. 4Department of Anatomy, College of Medicine, University of the Philippines- Manila, Manila, Philippines
  1. Correspondence to Dr Jose Danilo Bengzon Diestro, danni.diestro{at}gmail.com

Summary

Cor triatriatum sinistrum (CTS) is a congenital anomaly where the left atrium is divided into two compartments by a fibromuscular membrane. This report aims to add to the literature on a rare cardiac condition that can cause neurological morbidity. We report a case of a 19-year-old female with an infarct in the right middle cerebral artery (MCA) territory initially maintained on aspirin. Eighteen months later, she had recurrence of weakness, for which repeat transthoracic echocardiography (TTE) and re-evaluation of the first TTE demonstrated a hyperechoic membrane spanning the width of the left atrium, clinching the diagnosis of CTS. Despite anticoagulation with apixaban, she was admitted for a third stroke where she succumbed to hospital-acquired pneumonia. Among cases of CTS associated with stroke, anticoagulation and surgery were the main modes of treatment. This case has the longest follow-up and the first to demonstrate failure of antiplatelet therapy and anticoagulation.

  • Cardiovascular Medicine
  • Neurology
  • Stroke

https://doi.org/10.1136/bcr-2017-219763

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    Footnotes

    • Contributors JDBD is the physician in charge of the care of the patient and he was the one who wrote the initial draft of the article. JJR and EG managed the cardiovascular concerns of the patient and gave important inputs to this paper. JLP is the supervising consultant. All the authors equally contributed to the writing of this paper and approved the final version.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.