From sudden stroke to heart transplant: unmasking restrictive cardiomyopathy in an adolescent: a case report

Paediatric AIS is uncommon and frequently idiopathic, with cardioembolism accounting for ∼15% of adolescent cases. Restrictive cardiomyopathy, although rare, should be considered in the differential, as thromboembolic complications occur in up to one-third of patients, with nearly half of these involving the cerebral circulation. Importantly, stroke may be the first manifestation of the disease. Early cardiac screening, including ECG, chest radiography, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and echocardiography, is crucial in the early diagnostic work-up of paediatric AIS. Prompt recognition of diastolic dysfunction and atrial enlargement may accelerate diagnosis and inform timely referral for heart transplantation. In short, paediatric AIS, though rare, requires thorough diagnostic evaluation to identify potential cardioembolic sources.