Recurrent Cardio-embolic Cerebrovascular Accidents due to Lambl’s Excrescences?

Pramod Theetha Kariyanna^1, , Apoorva Jayaranagaiah², Yuliya Kats³ and Abhishek Sharma³

¹Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, New York, U.S.A.

²Department of Internal Medicine, Marshfield Clinic- St.Joseph Hospital, Marshfield, Wisconsin, U.S.A.

³Division of Cardiology, Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, New York, U.S.A.

Cite this paper:
Pramod Theetha Kariyanna, Apoorva Jayaranagaiah, Yuliya Kats and Abhishek Sharma. Recurrent Cardio-embolic Cerebrovascular Accidents due to Lambl’s Excrescences?. American Journal of Medical Case Reports. 2016; 4(3):93-96. doi: 10.12691/ajmcr-4-3-6

Abstract

Cerebrovascular accidents (strokes) are leading cause of morbidity and mortality in the United States of America. Cardioembolic strokes account for one-third of cerebrovascular accidents. Lambl’s excrescences are filiform projections on the native cardiac valves; they are attributed as a rare cause of cardioembolic strokes. They are a result of endothelial damage secondary to valve wear and tear. Lambl’s excrescences as a cause of cardioembolic stroke is debated. Lambl’s excrescences are a frequent appearance on echocardiography. We here present a case of recurrent cardioembolic strokes in whom lambl’s excrescences on aortic valves were detected on transesophageal echocardiography. Previous transthoracic echocardiography in the patient had not revealed lambl’s excrescences owing to their low sensitivity. Patient refused aortic valve replacement and medical management of cerebrovascular accident was continued.

Keywords:
Lambl’s excrescences aortic valve transthoracic echocardiography cardioembolic stroke

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