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European Journal of Echocardiography Advance Access published online on February 19, 2008
European Journal of Echocardiography, doi:10.1093/ejechocard/jen071
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Apical rotating flow and right ventricular cerebral compression

Jurren M. van Opstal*, Danielle V.J. Zaar and Emile C. Cheriex

Department of Cardiology, Academic Hospital Maastricht, P. Debyelaan 25, Maastricht 6202 AZ, The Netherlands

Received 22 October 2007; .

* Corresponding author. Tel: +31 621941644. E-mail address: jmvanopstal{at}yahoo.com


  Abstract

A 59-year-old male was admitted to the emergency room with signs of heart failure. The echocardiogram showed an extensive apical infarction with large mobile thrombi in the left ventricle. Doppler examination demonstrated apical rotating flow. Despite adequate anticoagulant therapy, the patient suffered a massive right-sided cerebral infarction leading to right ventricular cerebral compression. The thrombogenic risk of apical rotating flow and the need for anticoagulation are discussed.

Keywords: Apical rotating flow; Thrombus; Cerebral infarction


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