A 35-year-old woman with known dilated congestive cardiomyopathy presents with weakness in the left arm and leg and right-sided facial weakness. The best diagnosis is:
A. mural thrombosis of left atrium with embolism
B. mural thrombosis of right atrium with embolism
C. thrombophlebitis of left thigh with embolism
D. thrombophlebitis of right thigh with embolism
E. thrombosis of right middle cerebral artery branch
Yes. The best diagnosis is:
A. mural thrombosis of left ventricle with embolism
The patient’s history of dilated congestive cardiomyopathy increases the risk of mural thrombosis in the left ventricle. The symptoms of weakness in the left arm and leg and right-sided facial weakness suggest a left middle cerebral artery (MCA) embolic stroke.
Mural thrombosis in the left ventricle can lead to embolism, which travels through the aorta and into the left MCA, causing the observed neurological deficits.