Transient ischaemic attack in a young woman

A previously asymptomatic woman in her 40s presented to the emergency with sudden onset of weakness of the right side upper and lower limbs and slurring of speech. Her symptoms improved entirely within 24 hours. Cardiac examination revealed a loud first heart sound and a short mid-diastolic rumble at the apex. ECG showed normal sinus rhythm. Non-contrast CT of the head done in the emergency was normal. Transthoracic echocardiogram image in apical four-chamber view is shown in figure 1. Figure 1 Echocardiogram in apical four chamber view showing a multilobular mass (arrows) in the left atrium during ventricular …