Left atrial septal pouch causing an ischaemic stroke in association with aortic coarctation

A 61-year-old lady presented with recurrent right middle cerebral artery (MCA) territory stroke. She had a previous stroke 3 years earlier which was investigated with transthoracic echocardiogram, Holter monitor, and carotid Doppler, but no thrombo-embolic source was identified. She has been on Asasantin® SR 200/25 for secondary stroke prevention since then. She also had a history of hypertension secondary to coarctation of the descending thoracic aorta which was …