Left atrial appendage thrombus and PFO in a patient diagnosed TIA with sinus rhythm: a case report

Background: The detachment of the left atrial appendage(LAA) thrombus is the major cause of cardioembolic stroke(CES)/cardioembolic transient ischemic attack(CETIA). A LAA thrombus is very infrequently detected in the presence of sinus rhythm. Patent foramen ovale(PFO) is another common reason for CES/CETIA, especially among young and middle-aged people. Case Presentation We reported a case of a 46-year-old man who presented with TIAs and was subsequently found with PFO and LAA thrombus despite being in sinus rhythm and basically normal structure and function. Anticoagulant treatment was effective, and there was no recurrence of TIA or stroke. Conclusion: LAA thrombus could occur in sinus rhythm and normal structure and function. The PFO may be an innocent bystander in the patient suspected of CES/CETIA. Percutaneous PFO closure should be cautiously chosen.