Boala Ebstein, factor de risc pentru accidentul vascular ischemic la tineri | [Ebstein disease, a risk factor for ischemic stroke in young people]

Abstract

Ebstein disease is a congenital heart abnormality characterized by abnormally low insertion to the right ventricular apex of the tricuspid valve. It is often associated with an atrial septal defect, in which case there is a communication between the right and left cavities of the heart that favors paradoxical embolism, an important risk factor for stroke. We will present the case of a 25-year-old after-birth female patient, known for Ebstein disease, and osteum secundum septal defect with right-sided hemiparesis and mixed aphasia. Cerebral CT was performed and it revealed a left-sided silvian ischemic stroke. Paraclinical explorations and the presence of the stroke without an obvious embolic source in the arterial circulation, and of the right-left shunt cardiac defect, direct the diagnosis to paradoxical embolism. Cardiac failure has become symptomatic in young adults and has caused brain complications. Surgical closure of the shunt is required to prevent paradoxical embolic events.