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A woman in her 70s presented with acute right arm paresis. Her medical history was significant for diabetes mellitus, hypertension, dyslipidaemia and hypothyroidism, all well controlled with medication. For the previous 2 months she had fibromyalgia for which pregabalin 50 mg per day was prescribed with little improvement. Her ECG showed non-specific ST-T abnormalities, the high sensitivity cardiac troponin I (hs-cTnI) was moderately elevated and an increased eosinophil blood count (EBC) of 2.2 k/µl was noticed. Although the brain CT at the emergency department was negative, she was admitted with a working diagnosis of ischaemic stroke. The next day the patient’s symptoms abated. On day 3 a second brain CT showed a minor embolic lesion of the left hemisphere. Transthoracic echo detected a big mass of the left ventricle (LV) …
Contributors All three authors contributed to patient evaluation and management. AA drafted the initial manuscript, which was reviewed by TM and AG.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; internally peer reviewed.
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