Low CHA2DS2-Vasc Score with High Risk of Stroke

Clinical Image

Austin Intern Med. 2018; 3(1): 1022.

Low CHA2DS2-Vasc Score with High Risk of Stroke

Kun-Tai Lee1,2* and Chang-Jen Chen2

¹Department of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

²Cardiovascular Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

*Corresponding author: Kun-Tai Lee, Cardiovascular center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

Received: January 11, 2018; Accepted: February 09, 2018; Published: February 22, 2018

Keywords

Atrial fibrillation; Spontaneous echo contrast

Clinical Image

A 55-year-old man with symptomatic drug-refractory paroxysmal Atrial Fibrillation (AF) was arranged to receive catheter ablation of AF. The CHA2DS2-VASc score is zero and no anticoagulant was prescribed before ablation. Computed tomography of the heart revealed normal size of the left atrium and no thrombus in the left atrial appendage. AF attacked one day before ablation and spontaneously terminated at the start of general anesthesia for ablation. The intracardiac echocardiography revealed spontaneous echo contrast, “smoke”, in the both right and left atria in sinus rhythm (Figure 1). Although electricity was converted spontaneously to sinus rhythm, the mechanical function of atria did not completely recover. Ablation procedure was terminated due to high risk of stroke. Although with a CHA2DS2-VASc score of zero, the paroxysmal AF patient has high risk of stroke. The anticoagulant was prescribed to this patient for stroke prevention after discharge.

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Citation: Lee K-T and Chen C-J. Low CHA2DS2-Vasc Score with High Risk of Stroke. Austin Intern Med. 2018; 3(1): 1022.