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Ischaemic stroke with intact atrial septum – exclude arteriovenous malformations

Published online by Cambridge University Press:  25 January 2013

Friederike Doering ,
Andreas Eicken  and
John Hess
Friederike Doering*
Affiliation:
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, München, Germany
Andreas Eicken
Affiliation:
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, München, Germany
John Hess
Affiliation:
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, München, Germany
*
Correspondence to. Dr med. F. Doering, Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse 36, 80636 München, Germany. Tel: 0049 89 1218 3305; Fax: 0049 89 1218 3333; E-mail: doering-f@web.de
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Abstract

A 44-year-old woman was referred to our centre for interventional cardiac catheterisation. The diagnostic work-up after a preceding ischaemic stroke led to the assumption of a patent foramen ovale due to a positive bubble study. Before the planned percutaneous closure of the patent foramen ovale, we performed a second bubble study, which showed an intact atrial septum. However, after two to three heart cycles bubbles could be detected in the left atrium, assuming a right-to-left shunt of an extracardiac origin most likely in the lung. We therefore performed cardiac catheterisation, yielding a pulmonary arteriovenous malformation in the lower lobe of the right lung. This was successfully closed interventionally by placing a Cook coil, as well as several plugs into the malformation and feeding vessels.

Type
Brief Reports
Information
Cardiology in the Young , Volume 24 , Issue 1 , February 2014 , pp. 145 - 147
Copyright
Copyright © Cambridge University Press 2013 

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