case_images: PMC5637824_01
case_images: (a) Head CT at time of admission showing no acute findings. (b) Subsequent head CT showing acute multiembolic stroke (arrows).
case_images: CRIC2017-9072523.001.jpg
case_images: PMC5637824_01_CRIC2017-9072523.001.jpg
case_images: fig1
case_images: IV diuretics were started. Initial head computed tomography (CT) scan showed no new or acute processes (Figure 1(a)). Interrogation of the patient's implantable cardioverter defibrillator revealed no evidence for significant arrhythmias. A repeat head CT scan revealed multiple acute embolic infarcts in the bilateral posterior temporal lobes, left occipital lobe, and posterior right middle cerebral artery involving the parietal and temporal lobes (Figure 1(b)).
case_images: Ramp study analysis showing LVEDD slope of -0.05. An LVEDD slope >= -0.16 is consistent with flow obstruction due to pump thrombosis. LVEDD = left ventricular end-diastolic dimension. RPM = revolutions per minute.
case_images: CRIC2017-9072523.002.jpg
case_images: PMC5637824_01_CRIC2017-9072523.002.jpg
case_images: fig2
case_images: From a baseline LVAD speed of 9000 rpm, echocardiogram images were then obtained in stepwise increments from 8600 rpm to 12000 rpm (Figure 2).