A 28-year-old male, who was known case of mitral valvular heart disease developed weakness on the right side of the body which gradually recovered completely over a period of 2 weeks. Blood pressure of the patient was normal and laboratory studies did not reveal any significant abnormality. What is the diagnosis?

**Core Concept:** Mitral valvular heart disease is a medical condition characterized by abnormalities in the mitral valve, leading to various symptoms and complications. In this case, the patient's weakness on the right side of the body, normal blood pressure, and normal laboratory studies suggest a possible neurological complication from a cardiac cause.

**Why the Correct Answer is Right:** The correct answer, C. Post-ischemic cerebral infarction, is the result of reduced blood flow to the brain due to mitral valvular heart disease. The patient's weakness on the right side of the body could be due to a cerebral infarction, which is a localized area of cell death caused by decreased blood flow. In this case, the reduced blood flow to the brain could be secondary to mitral valvular heart disease leading to left-sided heart failure. With improved cardiac function, the cerebral blood flow might have improved and caused the right-sided weakness to resolve.

**Why Each Wrong Option is Incorrect:**

A. Ischemic stroke (B) and hemorrhagic stroke (D) are separate entities not related to mitral valvular heart disease. While stroke can be a complication of heart disease, the specific condition described here is not stroke but post-ischemic cerebral infarction.

B. Hemiparesis (weakness) due to a stroke (B) or hemorrhagic stroke (D) would typically occur on one side of the body, whereas the patient's weakness occurred on the right side of the body. Additionally, the recovery time is usually shorter than 2 weeks.

**Clinical Pearl:** The clinical scenario described highlights the importance of considering cardiac causes for neurological symptoms, especially when they improve over time. Mitral valvular heart disease can lead to left-sided heart failure, which can indirectly affect cerebral blood flow and cause neurological symptoms like weakness on the right side of the body. As the cardiac condition improves, the neurological symptoms might also improve, as seen in this case.

✓ Correct Answer: B. Ischemic stroke