The patient was a 42-year-old male with no relevant medical history.
She walks daily for an hour, is not hypertensive, dyslipidemic, or smoker and denies the intake of alcohol or other drugs.
There is no relevant direct family history.
He was evaluated in our center with sudden paresis of the right upper limb and dysarthria, which were self-limited in twenty minutes.
The patient reported no other symptoms.
In the general physical examination, there were no relevant data, and her blood pressure was 140 mmHg.
Neurological examination, apart from acute motor deficit, was strictly normal.
No pathological changes were found in the cranial imaging tests performed (cranial magnetic resonance angiography, contrast-enhanced computed tomography and magnetic resonance angiography), in the electroencephalogram, or in the evoked potentials.
Chest radiography and transthoracic echocardiography were normal.
Arterial Doppler of the supraaortic trunks showed no atherosclerotic plaques.
Analytical study (general biochemistry, lipids, liver profile, renal function, coagulation study, VSG, PCR, proteinogram, urinary sediment, blood count, luetic serology, antinuclear antibodies, and rheumatoid factor) showed no
In order to rule out hypercoagulable states, antiphospholipid antibodies such as activated phosphodiesterase, factor V, antithrombin III, G20210A mutation of prothrombin deficiency, homocysteine protein C
None of them had pathological values.
A transesophageal echocardiography (TEE) was performed, showing the absence of foramen ovale permeability at baseline, using contrast and after performing the Valsalva maneuver.
There were no atherosclerotic plaques in the visible course of the aorta.
A philate, mobile, 9 mm image was visualized, visible both on the arterial side and on the ventricular side of the aortic valve.
These findings consistent with aortic valve stenosis were treated with 200 mg of acetylsalicylic acid daily.
In the outpatient follow-up performed during the first year, the patient was asymptomatic and TEE performed at the end of this period confirmed the persistence of valvular excrecy.
