Acute Ischemic Stroke as a Manifestation of Secondary Polycythemia in a Patient of Adult Complex Cyanotic Congenital Heart Disease: A Case Report

It is widely recognized that polycythemic patients with cyanotic congenital heart disease (CCHD) are at an increased risk for developing cerebrovascular accidents in the pediatric age-group. The literature provides conflicting and scarce data related to the prevalence of such events among the adult population. A prevalence rate of 10-13% of stroke and transient ischemic attacks has been reported in a cohort of adult patients with complex CCHD, but others have claimed that such events are rare. The treatment of hyperviscosity secondary to polycythemia with prophylactic phlebotomy is only rarely used in such patients, as it has been reported to result in decreased exercise tolerance and an increased frequency of stroke events. We describe a case of an adult male with CCHD and secondary polycythemia, manifesting as an acute ischemic stroke.