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[Hypoperfusion of the brain in cardiac rhythm disorders]
1Oddĕlení Funkcního Vysetrování OUNZ Vyskov.
Insights
Severe cardiac rhythm disorders, specifically ectopic ventricular contractions, were found to cause transient ischemic attacks in 86% of affected patients. Poorer blood flow in extreme head and neck positions can also contribute to ischemic events.
Area of Science:
- Neurology
- Cardiology
- Medical Imaging
Context:
- Transient ischemic attacks (TIAs) pose significant risks for cerebrovascular events.
- Assessing the impact of cardiac dysrhythmias on cerebral circulation is crucial for understanding TIA etiology.
- Objective criteria are needed to link hemodynamic changes to neurological symptoms.
Purpose:
- To investigate the relationship between cardiac rhythm disorders and transient ischemic attacks (TIAs).
- To develop objective criteria for evaluating hemodynamic impacts on cerebral blood flow.
- To determine the prevalence of dysrhythmia as a cause of TIAs in patients with specific cardiac conditions.
Summary:
- Ultrasonic Doppler and rheoencephalographic examinations were performed on 134 patients (age 41-74) with TIA symptoms.
- Criteria were established to objectively assess hemodynamic influences on cerebral circulation, considering ectopic ventricular contractions and pulse deficits.
- Dysrhythmia was identified as the cause of cerebral ischemia in 4.5% of all subjects and 86% of those with severe cardiac rhythm disorders.
Impact:
- This study provides objective criteria for diagnosing dysrhythmia-induced TIAs.
- Highlights the significant role of cardiac rhythm disturbances in TIA development.
- Suggests that compromised blood supply in extreme head/neck positions exacerbates ischemic risk.
Abstract:
In 134 patients (age 41-74 years) with symptoms of a transient ischaemic attack the authors made an ultrasonic dopplerometric examination of the main arteries of the head and a rheoencephalographic examination using the method of polygraphic recording with an ECG tracing II. st. 1. as well as in extreme position of the head and neck. In the investigated group in seven subjects a severe disorder of the cardiac rhythm was recorded with more than one third of ectopic ventricular contractions. The authors elaborated criteria for the objective expression of the impact of haemodynamic changes on the cerebral circulation. When doing so, they took into account the number of inadequate ventricular contractions with a pulse deficit in the periphery, the frequency of inadequate contractions and their haemodynamic effect the consequence of which was reduction of the pulse volume and slowing down of the blood flow. According to these criteria dysrhythmia was the cause of cerebral ischaemia in 4.5% of all subjects included in the authors' group. In the group of patients with a severe disorder of the cardiac rhythm dysrhythmia was the cause of a transient ischaemic attack in 86% of the patients. Trespassing of the ischaemic threshold is promoted also by a poorer blood supply in extreme positions of the head and neck which may occur in everyday life or during sleep.