{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T07:43:53Z","timestamp":1785483833279,"version":"3.56.0"},"reference-count":13,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,10,13]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:p>A 65-year-old woman presented to the emergency department with an acute onset of left-sided hemiparesis and slurred speech for 6\u2009hours. Physical examination was notable for clubbing and peripheral cyanosis. Brain MRI showed an acute infarct involving the right gangliocapsular region. Investigations showed an elevated haemoglobin level, a haematocrit level of &gt;65%\u2009and thrombocytopaenia. Transthoracic echocardiography revealed tricuspid atresia, ventricular septal defect and atrial septal defect. A diagnosis of cyanotic congenital heart disease was made. Studies have indicated an association between raised haematocrit and vascular occlusive episodes in patients with polycythaemia vera. However, a relationship between raised haematocrit due to polycythaemia secondary to complex congenital heart disease and vascular thrombosis has not been reported. The improvement of neurological deficits in our patient coincided with a decline in haematocrit. The objective of this report was to highlight an association between elevated haematocrit and ischaemic stroke in patients with secondary polycythaemia due to complex congenital heart disease.<\/jats:p>","DOI":"10.1136\/bcr-2019-231261","type":"journal-article","created":{"date-parts":[[2019,10,30]],"date-time":"2019-10-30T10:29:31Z","timestamp":1572431371000},"page":"e231261","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Acute ischaemic stroke in secondary polycythaemia due to complex congenital cyanotic heart disease"],"prefix":"10.1136","volume":"12","author":[{"given":"Jeyaraj Durai","family":"Pandian","sequence":"first","affiliation":[{"name":"Department of Neurology, Christian Medical College & Hospital Ludhiana, Ludhiana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivy Anne","family":"Sebastian","sequence":"additional","affiliation":[{"name":"Department of Neurology, Christian Medical College & Hospital Ludhiana, Ludhiana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5851-8836","authenticated-orcid":false,"given":"Ashlee","family":"Sidhu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Christian Medical College & Hospital Ludhiana, Ludhiana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,10,30]]},"reference":[{"key":"2025082706475336000_12.10.e231261.1","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1111\/chd.12220","article-title":"Epidemiology of congenital heart disease in India","volume":"10","author":"Bhardwaj","year":"2015","journal-title":"Congenit Heart Dis"},{"key":"2025082706475336000_12.10.e231261.2","doi-asserted-by":"crossref","unstructured":"Thorne SA . 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