JACC. Case reports · 2026
Ischemic Stroke as the Presenting Feature of Anterior STEMI Complicated by LV Thrombus and Pseudoaneurysm.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hasan Ibrahim, Hasan Nebras, Sfeir Pierre, El Sayegh Noura, Refaat Marwan M, Ghazzal Ziyad
Аннотация
BACKGROUND: Delayed presentation of anterior ST-segment elevation myocardial infarction (STEMI) increases the risk of thromboembolic and mechanical complications.
CASE SUMMARY: We report a 41-year-old man who presented with transient right upper extremity weakness and dysarthria and was found to have electrocardiographic evidence of an old anterior myocardial infarction. He experienced chest pain 3 days earlier without seeking medical attention. Cardiac catheterization revealed thrombotic lesions involving the left anterior descending artery and diagonal bifurcation. Echocardiography demonstrated moderately reduced left ventricular systolic function with a large apical thrombus. Brain magnetic resonance imaging showed a small acute ischemic infarct. He was managed medically with antithrombotics and heart failure therapy. Eight weeks later, regular follow-up imaging revealed severe left ventricular dysfunction, aneurysmal remodeling, and pseudoaneurysm formation, requiring urgent surgical repair.
DISCUSSION: This case highlights the dynamic progression from thromboembolic to mechanical complications following delayed-presentation STEMI and underscores the importance of early recognition, multimodality imaging, and close follow-up.
TAKE-HOME MESSAGES: Delayed-presentation anterior STEMI may first manifest as acute ischemic stroke because of left ventricular thrombus. Close follow-up and multimodality imaging are essential to detect late mechanical complications such as left ventricular pseudoaneurysm.
CASE SUMMARY: We report a 41-year-old man who presented with transient right upper extremity weakness and dysarthria and was found to have electrocardiographic evidence of an old anterior myocardial infarction. He experienced chest pain 3 days earlier without seeking medical attention. Cardiac catheterization revealed thrombotic lesions involving the left anterior descending artery and diagonal bifurcation. Echocardiography demonstrated moderately reduced left ventricular systolic function with a large apical thrombus. Brain magnetic resonance imaging showed a small acute ischemic infarct. He was managed medically with antithrombotics and heart failure therapy. Eight weeks later, regular follow-up imaging revealed severe left ventricular dysfunction, aneurysmal remodeling, and pseudoaneurysm formation, requiring urgent surgical repair.
DISCUSSION: This case highlights the dynamic progression from thromboembolic to mechanical complications following delayed-presentation STEMI and underscores the importance of early recognition, multimodality imaging, and close follow-up.
TAKE-HOME MESSAGES: Delayed-presentation anterior STEMI may first manifest as acute ischemic stroke because of left ventricular thrombus. Close follow-up and multimodality imaging are essential to detect late mechanical complications such as left ventricular pseudoaneurysm.