Case report
Young-onset Ischaemic Stroke Secondary to Antiphospholipid Syndrome Associated with Mitral Valvular Lesion: A Case Report
OD24-OD27
Correspondence
Dr. Vignessh Raveekumaran,
Assistant Professor, Department of General Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed to be University), Puducherry-607402, India.
E-mail: vignesshravee@gmail.com
Young-onset ischaemic stroke warrants evaluation for uncommon aetiologies, particularly autoimmune and hypercoagulable disorders. Antiphospholipid Syndrome (APS) is an important cause of ischaemic stroke in young adults and is frequently associated with recurrent pregnancy loss and cardiac valvular lesions. A 32-year-old hypertensive female presented with weakness of the left lower limb for three days. Neurological examination revealed monoparesis with exaggerated reflexes and bilateral extensor plantar responses. Magnetic Resonance Imaging (MRI) of the brain demonstrated multiple acute non haemorrhagic infarcts in the right frontoparietal region, along with evidence of previous infarction. Echocardiography revealed a highly mobile echogenic mass attached to the posterior mitral leaflet associated with mitral regurgitation, suggestive of a cardioembolic source. Laboratory investigations demonstrated prolonged activated Partial Thromboplastin Time (aPTT), positive lupus anticoagulant, elevated anticardiolipin Immunoglobulin G (IgG) antibodies, and positive Antinuclear Antibody (ANA) titre. A history of recurrent pregnancy loss further supported the diagnosis of secondary APS with probable cardioembolic stroke. Young stroke associated with adverse obstetric history should raise suspicion for APS. Cardiac valvular lesions in APS may act as embolic sources and contribute to recurrent ischaemic events. Early diagnosis and multidisciplinary management are essential to prevent recurrent thrombotic complications and improve long-term neurological outcomes.