A 55-year-old man with known ischemic heart disease dies suddenly 2 weeks after an acute MI. Autopsy reveals a left ventricular aneurysm filled with a mural thrombus. Through which mechanism did this aneurysm most likely cause a fatal stroke?
- A Thromboembolism to cerebral arteries causing ischemic stroke ✓
- B Septic emboli causing cerebral abscess
- C Rupture causing hemorrhagic stroke
- D Vasospasm of cerebral arteries
Correct answer: A. Thromboembolism to cerebral arteries causing ischemic stroke
Explanation
Left ventricular aneurysm is a complication of large transmural MI, typically forming weeks after infarction. Stasis within the aneurysmal sac leads to mural thrombus formation, which can embolize to cerebral arteries causing ischemic stroke. This is the classic mechanism of thromboembolic stroke post-MI. Ventricular aneurysms do not rupture as commonly as free wall rupture in the early period. Robbins 10th ed, Chapter 12.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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