Syed Saad Mahmood1, Sunil Manjila2, Gagandeep Singh3, Andrew R Xavier4. 1. Department of Medicine, Massachusetts General Hospital, Boston, MA, USA. 2. Department of Neurological Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA. 3. Department of Neurology, University Hospitals Case Medical Center, Cleveland, OH, USA. 4. Department of Neurosurgery, Wayne State University, Detroit, MI, USA.
Abstract
BACKGROUND AND PURPOSE: Transesophageal echocardiography (TEE) is a relatively safe imaging modality used to visualize intracardiac thrombus. SUMMARY OF CASE: We report on a unique, fatal complication during TEE of embolization of a pre-existing "smoking" left atrial thrombus causing acute bilateral internal carotid occlusion, confirmed on angiogram. CONCLUSIONS: Patients with history of lung pathology, such as COPD, who experience retching and cough during transesophageal echocardiography may be more susceptible to embolization of pre-existing thrombi. A need exists to risk stratify such patients.
BACKGROUND AND PURPOSE: Transesophageal echocardiography (TEE) is a relatively safe imaging modality used to visualize intracardiac thrombus. SUMMARY OF CASE: We report on a unique, fatal complication during TEE of embolization of a pre-existing "smoking" left atrial thrombus causing acute bilateral internal carotid occlusion, confirmed on angiogram. CONCLUSIONS:Patients with history of lung pathology, such as COPD, who experience retching and cough during transesophageal echocardiography may be more susceptible to embolization of pre-existing thrombi. A need exists to risk stratify such patients.
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