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Case of Paradoxical Embolic Transient Ischemic Attack from an Unusual Extra Cardiac Shunt Detected on a Contrast‐Enhanced Echocardiogram
Author(s) -
Sheikh Mujeeb,
Emery Marie,
Curtis Allison,
King Stacie,
Colyer William R.
Publication year - 2014
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12408
Subject(s) - shunt (medical) , cardiology , transient (computer programming) , medicine , contrast (vision) , transesophageal echocardiogram , transthoracic echocardiogram , computer science , artificial intelligence , operating system
Paradoxical embolism due to extracardiac right to left shunts ( RLS s) manifesting as stroke remains anecdotal. We describe a case of 63‐year‐old female who presented with a transient ischemic attack and at agitated saline contrast echocardiogram was found to have an unusual type of an extracardiac RLS . Further evaluation leads to diagnosis of superior vena cava ( SVC ) thrombosis from a prior indwelling central venous catheter. The SVC thrombosis induced systemic‐pulmonary venous collaterals were responsible for this unusual extracardiac RLS and paradoxical transient ischemic attack. We discuss the diagnosis and management of this rare clinical case .