A Case Report of Stroke in a Woman with Paradoxical Embolism Associated with Ebstein\'s Anomaly

Abstract

Introduction: Ebstein's anomaly (EA) is a rare congenital malformation of the tricuspid valve, often associated with PFO, which is present in 80-90% of patients & predisposes to para-doxical embolization. Case Report: The case described was a 30 year old female, in the post partum phase, (ten days after normal vaginal delivery) who was presented to the emergency department with seizure & Rt sided hemiplegia & aphasia. On brain computed tomography scan there was large in-farct of Lt sided hemisphere in fronto temporopartial, and her brain MRI subsequently con-firmed the infarct. Laboratory tests including coagulation study & infectious tests were nor-mal. But electrocardiogram showed AG block grade I. Trans thoracic and Trans esophageal echocardiography revealed Ebstein's anomaly. Dynamic cardiac MRI showed severe tricus-pid regurgitation due to sown ward displacement of tricuspid valve to apical heart associated with patent foramen oral & ASD (Ejection fraction of right chamber was normal and no evi-dence of clot). Conclusion: After ruling out the other diagnoses, paradoxical emboli was considered as the cause leading to the stroke in this case.

Keywords

• ebstein\'s anomaly
• cerebrovascular disorders
• paradoxical embolism