Frequency of echocardiographic abnormalities in patients with ischemia of the carotid territory--a preliminary report.

Abstract

SUMMARY Eighty-eight consecutive patients referred to a neurosurgical Department (63 men and 25 women) aged from 14 to 68 years, with cerebral ischemia in the carotid territory were subjected to M-niode and two-dimensional echocardiography, carotid angiography and assessment of risk factors. There were 27 patients (average age 54 years) in whom carotid angiography demonstrated a probable source for the ischemia. Carotid angiography was normal in 51 of the remaining 61 (average age 39 years) while 10 revealed distant emboli. Although the incidence of "abnormal echocardiograms" was similar in the two groups (56% and 54% respectively) the spectrum of abnormalities were different. Only 5 (18%) of the 27 patients with abnormal angiograms had a potential cardiac source of emboli while 24 (39%) out of the remaining 61 patients had a potential cardiac source demonstrated at echocardiography. There was a high incidence of mitral valve prolapse (34%) in this latter group of patients. Mitral valve prolapse was not seen in the present series in patients with a probable carotid source on angiography.

Anticardiolipin Antibody and Stroke: Possible Relation of Valvular Heart Disease and Embolic Events

“…Thus, in populations unselected for Acia, the reported prevalence of embolic strokes ranges from 13 to 24% [32]; even among younger stroke patients, most compa rable to those in our series, emboli account for 35-39% of strokes [33][34][35], While the small size of the present series precludes firm conclusions, our data suggest a higher preva lence of embolic etiology in young Acla-positive stroke patients than in a comparable unselected population, pointing to a more uniform and unique pathophysiology in the Acla-positive group.…”

“…This conclusion is con sistent with several recent case reports and small series describing échocardiographie, autopsy and cerebral imaging data among patients with Ada [5,7] or lupus anticoagu lant [25][26][27][28][29][30][36][37][38][39][40] and ischemic neurologic events: a possible association with valvular disease is readily inferrable from these re ports. Importantly, the frequency of poten tially emboligenic échocardiographie valvu lar abnormalities among our entire group of Acla-positive patients with stroke (80%) is considerably higher than that expected among patients not selected for Ada with non-hemorrhagic stroke (0-11%) [33,41,42] and also is higher than the frequency of all échocardiographie abnormalities in unse lected stroke populations (4-16%) [43], even among younger stroke patients most compa rable in age to our series (21-33%) [14,41,44], It must be noted again, however, that the small size of the present series precludes confident comparison with these earlier studies.…”

The potential role for ultrafast cardiac computed tomography in patients with stroke.

“…12 The latter not only suggests coexistent atheromatous involvement of the brain vasculature but also carries prognostic significance for the incidence and outcome of cerebral ischemia. 3 -5 Accurate detection of cardiovascular pathology provides the ability to make rational diagnostic and therapeutic decisions for preventing further cerebrovascular accidents and for improving stroke outcome.…”

Cardiac and Arterial Lesions in Carotid Transient Ischemic Attacks

“…10 ing the guidelines of the ad hoc commit¬ tee": hemiparesis, hemisensory deficit, loss of vision in one eye, aphasia or dysarthria, alone or in combination, eventually in association with a visual hemifield defect.…”