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[Cardiopathy and acute cerebrovascular insufficiency. Prospective study with two-dimensional echocardiography]
Insights
Echocardiography identified cardiac conditions in 14.4% of patients with cerebrovascular insufficiency. Early detection and treatment of these cardiac causes improved patient outcomes, preventing further strokes.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Acute cerebrovascular insufficiency can stem from various cardiac disorders.
- Early identification of cardiac causes is crucial for patient management and prognosis.
- Echocardiography is increasingly recognized for screening cerebral ischemia patients.
Purpose of the Study:
- To assess the prevalence of potentially embolic cardiac conditions in patients with cerebrovascular insufficiency.
- To evaluate the role of echocardiography in identifying these cardiac conditions.
- To explore the relationship between cardiac findings and cerebrovascular events.
Main Methods:
- 180 consecutive patients with cerebrovascular insufficiency underwent clinical cardiological evaluation and echocardiography.
- Echocardiograms were analyzed for cardiac lesions.
- Patients were grouped based on cerebral angiography results.
Main Results:
- Cardiac lesions were detected in 14.4% (22/153) of patients with adequate echocardiograms.
- Identified lesions included mitral stenosis, aortic stenosis, endocarditis, cardiomyopathies, mitral valve prolapse, and left ventricular dyskinesia.
- A higher incidence of cardiac disease was noted in patients with normal cerebral angiography, suggesting a cardiac origin for their stroke.
Conclusions:
- Echocardiography is valuable in detecting embolic cardiac sources in patients with cerebrovascular insufficiency.
- In 10 patients with no cerebral angiography lesions but high-risk cardiac conditions, a causal link was established.
- Treatment (cardiac surgery or anticoagulation) in these 10 patients prevented recurrent cerebrovascular events over 18 months.
Abstract:
Many cardiac disorders can cause acute cerebrovascular insufficiency. The spectrum of potentially embolic cardiac conditions is wide; early recognition may determine a definite change in the management and prognosis of patients. In recent years the relevance of echocardiography in the screening of patients with cerebral ischemia has been emphasized. In order to identify potentially embolic cardiac conditions, 180 consecutive non selected patients with cerebrovascular insufficiency, underwent a clinical cardiological evaluation and an echocardiogram. The study population included 132 men and 48 women; the mean age was 51.7 years (range 19 to 72 years). A technically adequate echocardiogram was obtained in 153 patients. In 131 patients echocardiography was negative; cardiac lesions were detected in 22 patients (14.4%): mitral stenosis in 2, calcified aortic stenosis in 1, valvular endocarditis vegetations in 3, dilatative cardiomyopathy in 2, hypertrophic cardiomyopathy in 4, mitral valve prolapse in 4, regional left ventricular diskynesia in 5, mitral anulus calcification in 1. Patients were divided into 3 groups according to the results of cerebral angiography: 68 patients with normal angiography (Group I), 54 patients with atheromasic lesions on cerebral angiography (Group II), 31 patients in whom cerebral angiography was not performed (Group III). A higher incidence of cardiac diseases was found in the patients of Group I. The lack of lesions on cerebral angiography and the presence of embolic high-risk cardiac conditions strengthened a causal relationship of the cardiac disorder with cerebrovascular insufficiency in 10 of the 23 patients. In the mean follow-up period of 18 months of these 10 patients who underwent cardiac surgery or anticoagulation, no further attacks of cerebrovascular insufficiency were observed.(ABSTRACT TRUNCATED AT 250 WORDS)