7th March 2024

A 62-year-old man presents with sudden onset left sided hemiplegia.

A 62-year-old man presents with sudden onset left sided hemiplegia. He is from India and is visiting his son, who works in the UK. He has a past medical history of multiple myeloma. A CT scan done in the emergency department is normal and he is diagnosed to have an embolic stroke. ECG shows atrial fibrillation. Echocardiography reveals a thickened mitral valve with mitral stenosis, an enlarged left atrium, a thickened LV wall and a granular/sparkling appearance of the myocardium. What is the most likely underlying cause of his symptoms?

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