Simultaneous Thrombosis in a Normal Left Ventricle and Normal Carotid Artery in a Patient With a Stroke Secondary to Iron Deficiency Anemia

Abstract

Iron deficiency anemia (IDA) is implicated as a cause of stroke, particularly in young patients without cardiovascular disease. In such patients, thrombi sometimes form in carotid arteries or the aorta. We report here a patient with a stroke secondary to IDA with thrombi in the normal left ventricle and normal carotid artery. The patient was a 45-year-old woman with severe IDA who developed cerebral infarction in the right middle cerebral artery. She had no other thrombophilia or cardiovascular diseases. Echocardiography showed a left ventricular thrombus without cardiac disease, and the carotid ultrasound showed a mobile thrombus attached to the right internal carotid artery without atherosclerosis. Antithrombotic therapy with iron supplementation removed both thrombi within 2 weeks. This is the first case of IDA with a ventricular thrombus in a normal heart. This case identifies a new site for thrombosis in IDA and shows that patients with IDA may present with simultaneous thrombosis at separate sites. IDA must therefore be recognized as a cause of stroke or systemic embolism, particularly in patients without detectable cardiovascular disease. In such patients, it is important to conduct careful investigations to detect thrombosis. J Med Cases. 2014;5(6):351-354 doi: http://dx.doi.org/ 10.14740 /jmc1786w