A 51-year-old woman with a known history of rheumatic heart disease for 10 years, was admitted with decreased consciousness and new onset right-sided weakness. Chest CT and echocardiography posted, what is the most likely diagnosis?




Blood clot or vegetation sitting on the mitral valve is always a time bomb likely to get dislodged at any time to be carried away thro the rt carotid(in staght line with the the ascending Aorta) to be deposited in the brain thus resulting in sudden blockage of blood supply to the corresponding area which in turn results in nuerological deficits as described.

Large LA CLOT with thromembolic stroke seems to be a possibility. Echo shows calcified mitral valve with large mass in LA which may be 1) caseous mitral calcification most likely 2) ? large LA clot 3) endocarditis? Fungal ball

Large LA CLOT. Needs immediate IV Heparin and oral anti coagulants together with control of rhythm and inotropic support if required. Follow up monthly with INR and once there is resolution of hematoma, MVR is the only option.

Large LA thrombus with thromboembolism IV Heparin maintain APTT 55. And take the opinion of cardiac Surgeon

An embolus from rheumatic heart lodging into the middle cerebral artery and causing right sided hemiparesis

Clot embolosing. Especially if there is atrial fibrillation. An important cause of stroke in the young .

Possibly due to thrombo embolic episodes at brain underlying RHD and sum mitral valvular vegetations.

RHD with Large LA clot, ( B - V ). Embolic / Ischemic Lt. I C stroke with Rt. Hemiparesis

Ball valve thrombus.. Needs anticoagulation and mannitol.

Ball valve thrombus?

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