Infant Stroke Associated With Left Atrial Thrombus and Supraventricular Tachycardia

Author:

Pauley Rachel1ORCID,Mercier Elise L.2,Kumar Ashutosh3,Trescher William H.3,Mainali Gayatra3

Affiliation:

1. Department of Neurology, Division of Child Neurology, NYU Langone Medical Center, New York, NY, USA

2. Department of Pediatrics, Division of Child Neurology, St. Christopher’s Hospital for Children, Philadelphia, PA, USA

3. Department of Pediatrics, Division of Child Neurology, Penn State Health College of Medicine, Hershey, PA, USA

Abstract

We report a rare case of cardioembolic stroke in the setting of supraventricular tachycardia (SVT) in an infant. After a week of irritability, a 10-week-old male presented to the emergency department with SVT requiring treatment with adenosine. He developed right-sided hemiparesis and focal motor seizures. Imaging of the brain showed ischemic infarct in the left middle cerebral artery (MCA) territory. Echocardiogram showed a newly formed large left atrial intracardiac thrombus. A coagulopathy workup was negative. He was treated with beta-blocker and anticoagulation therapy. He had mild residual right hemiparesis. During childhood, he developed medically refractory focal epilepsy from the left hemisphere, requiring epilepsy surgery at age 10. A child presenting with sustained SVT can be at increased risk for intracardiac thrombi and stroke.

Publisher

SAGE Publications

Subject

General Economics, Econometrics and Finance

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