Echocardiography in stroke: a cross sectional study from central Nepal
Keywords:
stroke; heart disease; echocardiography; left ventricular hypertrophy.Abstract
Background: Stroke is an important cardiovascular disease with significant morbidity and mortality. Since the treatment is not much rewarding and mostly limited to use of anti-platelets, unless highly sophisticated neurological services is available, prevention is the paramount of importance in reducing the disease burden. The heart disease and stroke are interrelated in various ways. Echocardiography as a tool for structural and functional assessment of heart can reveal underlying abnormalities leading to stroke. We conducted an echocardiographic study to assess such abnormalities in a group of stroke cases.
Materials and Methods: A cross-sectional study was designed. A total of 105 subjects diagnosed as a case of stroke based on CT scan brain and referred for echocardiography, were selected and details of echocardiographic assessment of the structure and function of their heart were recorded. Unstable and severely ill subjects, and subjects with poor transthoracic acoustic windows were excluded from the study. Only 84 cases were included in the final analysis. Various echocardiographic abnormalities in these subjects were analyzed. Findings were reported as percentages or in absolute numbers.
Results: Mean age was 64+/-12 years, ranging from 26 years to 84 years. Male to female ratio was 2.5:1. Major significant echocardiographic findings in stroke subjects included: LV hypertrophy (68%), Sclerotic and calcific changes of aortic valves (64%), Mitral regurgitation (40%), Aortic regurgitation (28%), Reduced ejection fraction (30%), Dilated LA (10%), Dilated aorta (6%). Other abnormalities recorded in stroke cases included mitral stenosis, mitral valve prolapse, patent foramen ovale, spontaneous LA contrast, and LA thrombus.
Conclusion: Various echocardiographic abnormalities including LV hypertrophy and atherosclerotic changes of aortic cusps were quite common in stroke subjects. These factors might have putative role in strokes. Early recognition of these abnormalities and initiation of treatment and preventive measures can be crucial for stroke prevention.
