Cardiogenic Cerebral Embolism in Srinagarind Hospital

Abstract

Background  : Rheumatic heart disease is the most common of valvular heart disease in Thailand and contributes to cerebrovascular disease.

Objective : To study clinical features and recurrent rate of  cardiogenic cerebral embolism in Srinagarind Hospital

Design : Descriptive study

Setting : Srinagarind Hospital, Faculty of Medicine, Khon Kaen University

One hundred and ten patients who were diagnosed cardiogenic cerebral embolism in department of internal Medicine service between 1983 and 1989.

Measurement : Clinical features, history of previous stroke, underlying disease, atrial  fibrillation, left atrial colt  and recurrent rate by percentage.

Results : There were 110 cases, 48 male and 62 cases were female. The patients’ mean age at diagnosis was 48.36 years (20-89 years). The main symptoms were hemi paresis (97.27%), aphasia (35.45%), alternation of conscious (32.73%), seizure (11.82%) and hemi anesthesia (10.00%). Underlying diseases were rheumatic heart disease (79.10%), non-valvular AF (11.82%), ischemic heart disease (4.55%), congenital heart disease (2.73%), prosthetic valve (0.90%) and endocarditic (0.90%). Sixty-five patients had echocardiogram, left atrial thrombus was found in 13 cases (20.00%). The most common abnormal valve was mitral valve. A trial fibrillation was found in 54 cases(62.00%). Three patients developed recurrent stroke within 2 weeks. Mortality rate was 15.45%, the most common cause of death was brain herniation (64.70%).

Conclusion : Cardiogenic cerebral embolism was the most common cause of stroke in the young. The most common cause was mitral valve stenosis with atrial fibrillation. Recurrent rate within 2 weeks was 3.45%. The cause of death was brain herniation.