Cardioembolic Stroke secondary to Massive Stress-Induced Apical Thrombosis: A Clinical Conundrum relating to Anticoagulation Initiation

Takotsubo cardiomyopathy or stress is a condition characterized by acute and transient left ventricular systolic dysfunction in the absence of coronary heart disease, occurring after an emotional physical stressful event. Cardiac these patients suspected to be secondary catecholamine induced cardiac myocyte injury via cyclic AMP-mediated calcium overload due endothelial dysfunction. Even though takotsubo transient, it can lead complications. Left thrombus formation widely reported complication has incidence around 5-14% thromboembolic events like stroke. We report case with apical LV thrombus, complicated large cardioembolic This constitutes clinical conundrum, as would warrant prompt initiation anticoagulation, while severe ischemic stroke contraindication for immediate anticoagulation.