Evaluation of causal heart diseases in cardioembolic stroke by cardiac computed tomography

Figure 4 Mitral stenosis. A 70-year-old man with mitral stenosis and atrial fibrillation underwent cardiac computed tomography (CCT) to rule out obstructive coronary artery disease. A and B: Left ventricular outflow tract long axis (A) and short axis (B) reformatted CCT images (upper: Mid systole at 20% of the R-R interval; lower: Mid diastole at 80% of the R-R interval) show thickened anterior and posterior mitral valve leaflets (arrowhead) and restricted mitral valve opening, representing mitral stenosis. Associated severe enlargement of left atrium is also found; C: Axial early phase CCT image shows triangular filling defect in left atrial appendage (LAA, upper, arrow). Axial delayed phase CCT image also shows filling defect in LAA confirming LAA thrombus (lower, arrow); D: Atrial functional analysis shows severely impaired LA function. LA end-systolic volume, end-diastolic volume, and ejection fraction were 180.3 mL, 166.3 mL, and 8%, respectively.