Transient ischemic attack (TIA) is a common neurologic event, often secondary to cardiovascular pathology. Lambl’s excrescences (LEs) are rare, filiform, non-neoplastic structures most frequently found on left-sided heart valves and typically identified incidentally. Their causal relationship with embolic phenomena remains controversial due to limited high-quality evidence and the absence of formal management guidelines. We present the case of a 64-year-old woman with symptomatic LE diagnosed by transesophageal echocardiogram, manifesting as TIA and a negative workup for other causes, including a 12-month follow-up with a loop recorder. Also, we discuss diagnostic considerations and management strategies based on current literature.
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