47-year-old lady for laparotomy, left hemicolectomy and ileocolic resection
- Crohn’s disease – current descending colon and terminal ileum strictures
- Multiple previous surgeries 20 years ago
- Recurrent perianal abscesses
- Poorly controlled disease, on 10mg prednisolone and infliximab
- Cryptogenic occipital CVA in 2019
- No risk factors
- Cardiology and neurology review at time of event
- TTE, and bubble study performed – Reported as normal aside from ‘a probable pseudo-massin LA which could represent a side lobe artefact.’
- Holter showed Ventricular bigeminy – asymptomatic
- No further issues with CVA’s
Further investigations warranted?
- Is there an indication to repeat echo/bubble study?
- Consensus was no, reported as artifact and a repeat test is unlikely to change management.
- Suggested that we could discuss this with the cardiologist who reviewed at time
- Discussed with cardiologist, scans reviewed and happy that LA mass is artefact.
- Ventricular bigeminy ongoing, cardiologist feels benign in setting of normal LV systolicfunction and lack of symptoms