Abstract
A 68-year-old Japanese man was transported to our ER by ambulance because of a disturbance of consciousness. At that time, we diagnosed acute cerebral infarction in the left posterior cerebral artery area coexisting with left ventricular wall motion disorders. The patient was admitted to our hospital, and anticoagulation therapy was started immediately. Seven days after admission, we identified a thrombus formation in the left ventricle by ultracardiography, and so we increased the amount of anticoagulation medicine (heparin). On the 19th day after admission, he experienced a recurrence of cardiogenic cerebral infarction in a large area of the left middle cerebral artery. In the echocardiographic follow-up study, we saw that his cardiac wall motion had improved and the thrombus had disappeared. There are no previously reported cases complicated with possible Takotsubo cardiomyopathy and acute cerebral infarction at the time of emergency conveyance along with a recurrence of cerebral embolism from an intraventricular thrombus during the acute phase. To prevent an embolism, effective and safe treatment must be established in patients with acute ischemic stroke complicated with possible Takotsubo cardiomyopathy.
