Lambl’s Excrescence as an Etiology of Thromboembolism: Case Report and Literature Review
Lambl’s excrescence (LE), a rare thin linear fibrous thread of collagen and elastic fibrous tissue originating at closure margins of heart valve leaflets is considered a rare cause of thromboembolism, causing ischemic stroke, transient ischemic attack (TIA), acute coronary syndrome, or peripheral th...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-05-01
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| Series: | Clinical Medicine Insights: Case Reports |
| Online Access: | https://doi.org/10.1177/11795476231171391 |
| _version_ | 1827941831440072704 |
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| author | Mohammad Ala’ Alajjuri Omar Ala’ Alajjuri Firas Raouf Alani |
| author_facet | Mohammad Ala’ Alajjuri Omar Ala’ Alajjuri Firas Raouf Alani |
| author_sort | Mohammad Ala’ Alajjuri |
| collection | DOAJ |
| description | Lambl’s excrescence (LE), a rare thin linear fibrous thread of collagen and elastic fibrous tissue originating at closure margins of heart valve leaflets is considered a rare cause of thromboembolism, causing ischemic stroke, transient ischemic attack (TIA), acute coronary syndrome, or peripheral thromboembolism. The gold standard for diagnosing LE is transesophageal echocardiography (TEE). Due to the rarity of the disease and lack of significant research, no guidelines exist about the management of LE. Twenty-two papers about LE were reviewed, focusing on the management aspect aiming to assist in guideline publication. Articles were retrieved using PubMed database using “Lambl’s excrescences” as a keyword. All free full text papers up to 2023 were retrieved. In this report, we present the first publication of a case of a TIA secondary to LE in the United Arab Emirates. A 53-year-old male presented with transient attacks of left monocular blindness with complete recovery 2 days later. Extensive stroke work-up was negative, except for TEE, which showed an echo-dense linear mobile structure attached to the aortic surface of the aortic valve closure margin, suggesting LE. As no guidelines exist on the management of LE, the patient was started on Clopidogrel 75 mg daily and remained asymptomatic for 2 years. After reviewing the literature, we suggest the use of Aspirin for patients with ⩾1 embolic event attributed to LE while not on antiplatelets or anticoagulants, as it is the most used and recommended treatment option and is effective in preventing recurrent thromboembolic events. |
| first_indexed | 2024-03-13T09:49:36Z |
| format | Article |
| id | doaj.art-75d4e750b1724803b1dc0fdbb2573405 |
| institution | Directory Open Access Journal |
| issn | 1179-5476 |
| language | English |
| last_indexed | 2024-03-13T09:49:36Z |
| publishDate | 2023-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Medicine Insights: Case Reports |
| spelling | doaj.art-75d4e750b1724803b1dc0fdbb25734052023-05-24T18:03:19ZengSAGE PublishingClinical Medicine Insights: Case Reports1179-54762023-05-011610.1177/11795476231171391Lambl’s Excrescence as an Etiology of Thromboembolism: Case Report and Literature ReviewMohammad Ala’ Alajjuri0Omar Ala’ Alajjuri1Firas Raouf Alani2University of Sharjah, Sharjah, United Arab EmiratesAl Qassimi Hospital, Sharjah, United Arab EmiratesAmerican Hospital, Dubai, United Arab EmiratesLambl’s excrescence (LE), a rare thin linear fibrous thread of collagen and elastic fibrous tissue originating at closure margins of heart valve leaflets is considered a rare cause of thromboembolism, causing ischemic stroke, transient ischemic attack (TIA), acute coronary syndrome, or peripheral thromboembolism. The gold standard for diagnosing LE is transesophageal echocardiography (TEE). Due to the rarity of the disease and lack of significant research, no guidelines exist about the management of LE. Twenty-two papers about LE were reviewed, focusing on the management aspect aiming to assist in guideline publication. Articles were retrieved using PubMed database using “Lambl’s excrescences” as a keyword. All free full text papers up to 2023 were retrieved. In this report, we present the first publication of a case of a TIA secondary to LE in the United Arab Emirates. A 53-year-old male presented with transient attacks of left monocular blindness with complete recovery 2 days later. Extensive stroke work-up was negative, except for TEE, which showed an echo-dense linear mobile structure attached to the aortic surface of the aortic valve closure margin, suggesting LE. As no guidelines exist on the management of LE, the patient was started on Clopidogrel 75 mg daily and remained asymptomatic for 2 years. After reviewing the literature, we suggest the use of Aspirin for patients with ⩾1 embolic event attributed to LE while not on antiplatelets or anticoagulants, as it is the most used and recommended treatment option and is effective in preventing recurrent thromboembolic events.https://doi.org/10.1177/11795476231171391 |
| spellingShingle | Mohammad Ala’ Alajjuri Omar Ala’ Alajjuri Firas Raouf Alani Lambl’s Excrescence as an Etiology of Thromboembolism: Case Report and Literature Review Clinical Medicine Insights: Case Reports |
| title | Lambl’s Excrescence as an Etiology of Thromboembolism: Case Report and Literature Review |
| title_full | Lambl’s Excrescence as an Etiology of Thromboembolism: Case Report and Literature Review |
| title_fullStr | Lambl’s Excrescence as an Etiology of Thromboembolism: Case Report and Literature Review |
| title_full_unstemmed | Lambl’s Excrescence as an Etiology of Thromboembolism: Case Report and Literature Review |
| title_short | Lambl’s Excrescence as an Etiology of Thromboembolism: Case Report and Literature Review |
| title_sort | lambl s excrescence as an etiology of thromboembolism case report and literature review |
| url | https://doi.org/10.1177/11795476231171391 |
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