Đột quỵ tái phát và sự tiến triển của huyết khối thất trái trong quá trình điều trị bằng apixaban ở bệnh nhân mắc bệnh cơ tim thiếu máu cục bộ mức độ nặng: Báo cáo ca lâm sàng

Initial transthoracic echocardiogram performed in October 2021 demonstrates a large, immobile thrombus (indicated by the red arrow) firmly adherent to the apical wall of the left ventricle. The thrombus measured approximately 17.5×9.9 mm and appeared well-defined with no signs of mobility, suggesting chronicity and posing a potential risk for embolic events.

Computed tomography scan of the brain demonstrates multifocal areas of hypodensity in the right cerebral hemisphere with loss of gray-white matter differentiation, predominantly involving the frontal, parietal, and temporal lobes, with development of a hemorrhagic focus within the right frontal lobe.

Transthoracic echocardiogram obtained during the patient’s Emergency Department presentation in April 2022 for recurrent stroke. The image reveals a large, immobile thrombus firmly attached to the apical wall of the left ventricle, measuring 17.5×16.4 mm. The thrombus size had increased since the previous scan, indicating progression of the left ventricular thrombus. The thrombus is clearly marked by the red arrow.

Timeline illustrating the sequential progression of the patient’s clinical course in temporal order.

Baseline laboratory test results.