Study of transesophageal echocardiography in young patients (<40 years) with acute arterial ischemic stroke: A pilot study.
Patent foramen ovale
Stroke in young
Transesophageal echocardiography
Journal
Medical journal, Armed Forces India
ISSN: 0377-1237
Titre abrégé: Med J Armed Forces India
Pays: India
ID NLM: 7602492
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
15
09
2017
accepted:
12
07
2018
entrez:
6
2
2020
pubmed:
6
2
2020
medline:
6
2
2020
Statut:
ppublish
Résumé
The aim is to study cardiac abnormalities as detected by transesophageal echocardiography (TEE) in young patients (<40 years) presenting with acute ischemic arterial stroke. A cross-sectional observational study was conducted in young patients aged <40 years presenting with acute arterial ischemic stroke without any valvular heart disease, prosthetic valve, or previously diagnosed atrial fibrillation (AF). TEE was performed in all eligible patients preferably within the first week of the onset of ischemic arterial stroke. All patients with normal TEE underwent holter to rule out paroxysmal AF. Totally, 40 young patients were included in the study. Mean age was 35.17 (SD [standard deviation] ± 2.99) years. TEE abnormalities were noted in total 13 (32.5%) patients, of which patent foramen ovale was the most common cardiac abnormality in eight (20%) patients followed by left atrial appendage clot in three (7.5%) and atrial septal aneurysm in two (5%) patients. One patient (2.5%) was observed with atrial septal aneurysm along with a sieved septum. All the patients with normal TEE underwent holter, and four of 27 (14.8%) of these patients were noted to have paroxysmal AF. Cardiac abnormalities on TEE and holter were detected in 42.5% of the young patients with idiopathic arterial stroke. TEE abnormality was noted in 33% (13/40), whereas AF on holter was seen in 14.8% (4/27) with normal TEE. Thus, probable cardioembolic stroke was responsible for acute ischemic stroke in 42.5% (17/40) of young patients in the absence of valvular heart disease, prosthetic valves, and persistent/permanent AF.
Sections du résumé
BACKGROUND
BACKGROUND
The aim is to study cardiac abnormalities as detected by transesophageal echocardiography (TEE) in young patients (<40 years) presenting with acute ischemic arterial stroke.
METHODS
METHODS
A cross-sectional observational study was conducted in young patients aged <40 years presenting with acute arterial ischemic stroke without any valvular heart disease, prosthetic valve, or previously diagnosed atrial fibrillation (AF). TEE was performed in all eligible patients preferably within the first week of the onset of ischemic arterial stroke. All patients with normal TEE underwent holter to rule out paroxysmal AF.
RESULTS
RESULTS
Totally, 40 young patients were included in the study. Mean age was 35.17 (SD [standard deviation] ± 2.99) years. TEE abnormalities were noted in total 13 (32.5%) patients, of which patent foramen ovale was the most common cardiac abnormality in eight (20%) patients followed by left atrial appendage clot in three (7.5%) and atrial septal aneurysm in two (5%) patients. One patient (2.5%) was observed with atrial septal aneurysm along with a sieved septum. All the patients with normal TEE underwent holter, and four of 27 (14.8%) of these patients were noted to have paroxysmal AF.
CONCLUSION
CONCLUSIONS
Cardiac abnormalities on TEE and holter were detected in 42.5% of the young patients with idiopathic arterial stroke. TEE abnormality was noted in 33% (13/40), whereas AF on holter was seen in 14.8% (4/27) with normal TEE. Thus, probable cardioembolic stroke was responsible for acute ischemic stroke in 42.5% (17/40) of young patients in the absence of valvular heart disease, prosthetic valves, and persistent/permanent AF.
Identifiants
pubmed: 32020968
doi: 10.1016/j.mjafi.2018.07.006
pii: S0377-1237(18)30095-9
pmc: PMC6994759
doi:
Types de publication
Journal Article
Langues
eng
Pagination
47-50Informations de copyright
© 2018 Armed Forces Medical Services (AFMS).
Références
J Neurol. 2012 Apr;259(4):653-9
pubmed: 21927959
Vasc Health Risk Manag. 2015 Feb 24;11:157-64
pubmed: 25750539
Stroke. 2009 Jul;40(7):2343-8
pubmed: 19498192
J Stroke. 2015 Sep;17(3):229-37
pubmed: 26437990
Expert Rev Cardiovasc Ther. 2010 Jul;8(7):917-32
pubmed: 20602553
Eur J Neurol. 2006 Feb;13(2):146-52
pubmed: 16490045
Lancet Neurol. 2010 Nov;9(11):1085-96
pubmed: 20965437
Med Clin (Barc). 2008 Mar 1;130(7):241-5
pubmed: 18355423
Vasc Health Risk Manag. 2008;4(1):167-72
pubmed: 18629351
Rev Esp Cardiol. 2003 Jul;56(7):662-8
pubmed: 12855148
Arch Neurol. 1995 May;52(5):491-5
pubmed: 7733844
Neth Heart J. 2009 Oct;17(10):373-7
pubmed: 19949646
Neurology. 2012 Oct 23;79(17):1781-7
pubmed: 23054237
Neurologist. 2011 Jan;17(1):16-20
pubmed: 21192186