Cardiac complications in acute ischemic stroke.
Charles R Wira1, Emanuel Rivers, Cynthia Martinez-Capolino
1Yale School of Medicine, Department of Emergency Medicine and Acute Stroke Service, New Haven, Connecticut.
The Western Journal of Emergency Medicine
|January 7, 2012
Summary
Cardiac complications are common in acute ischemic stroke (AIS) patients. Conditions like systolic dysfunction and atrial fibrillation significantly increase in-hospital mortality risk, highlighting the need for cardiac monitoring in AIS care.
Area of Science:
- Cardiology
- Neurology
- Emergency Medicine
Background:
- Acute ischemic stroke (AIS) patients admitted from urban emergency departments (EDs) frequently experience cardiac complications.
- Characterizing these complications is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the prevalence and impact of cardiac complications in AIS patients.
- To identify specific cardiac issues associated with increased in-hospital mortality.
Main Methods:
- Retrospective cross-sectional study of AIS patients admitted within 24 hours of symptom onset.
- Included patients who underwent echocardiography within 72 hours of admission.
- Analyzed data on ejection fraction, ECG findings, atrial fibrillation, troponin levels, and arrhythmias.
Main Results:
- 8% in-hospital mortality rate observed in 200 AIS patients.
- 28.5% had reduced ejection fraction (<50%), 20.4% showed ischemic ECG changes, 10.5% had active atrial fibrillation, and 13.0% had elevated troponin.
- Systolic dysfunction, troponin elevation, atrial fibrillation, and ischemic ECG changes were linked to significantly higher mortality rates.
Conclusions:
- Cardiac complications are a significant concern in AIS patients.
- Specific findings like systolic dysfunction, troponin elevation, atrial fibrillation, and ischemic ECG changes are associated with increased mortality.
- These results underscore the importance of cardiac monitoring in the acute management of AIS.
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