Heart Brain Clinic: An Integrated Approach to Stroke Care

Area of Science:

• Neurology
• Cardiology
• Vascular Medicine

Background:

• Patent foramen ovale (PFO) is associated with stroke, particularly in younger individuals.
• Management requires coordinated care between cardiology and neurology specialists.
• Multidisciplinary clinics can improve patient outcomes and care efficiency.

Purpose of the Study:

• To evaluate the feasibility and impact of a multidisciplinary Structural Heart Brain Clinic (HBC) for patients with PFO-associated stroke.
• To compare the efficiency and decision-making process for PFO closure in patients managed through the HBC versus standard care.

Main Methods:

• Retrospective collection of demographic and clinical data for patients with PFO-associated ischemic stroke.
• Comparison of a standard care group with a group managed by the Structural HBC.
• Analysis of outcomes including time to PFO closure and number of clinic visits, using nonparametric and chi-square tests.

Main Results:

• The Structural HBC managed 79 patients, compared to 41 in the standard care group.
• HBC patients required significantly fewer clinic visits before a PFO closure decision (p = 0.001).
• Clinicians were more likely to recommend against PFO closure in the HBC group (p = 0.021), potentially due to selection bias.

Conclusions:

• A multidisciplinary, patient-centered approach through the HBC is feasible for managing PFO-associated stroke.
• This model may improve the quality of care for younger patients with PFO-associated stroke.
• Further research is needed to confirm improvements in broader care aspects and long-term outcomes.