ACUTE ISCHEMIC STROKE

ELECTROCARDIOGRAPHIC AND ECHOCARDIOGRAPHIC FINDINGS IN PATIENTS. (POTENTIAL SOURCE OF CARDIAC EMBOLI)

Abstract

Objectives: To determine the electrocardiographic and echocardiographic
findings in patients with acute ischemic stroke (potential source of cardiac emboli). Study
Design: Cross section descriptive study. Period: Six months. Setting: Liaquat University Hospital
Hyderabad. Patients and Methods: The subjects with history and clinical features suggestive
of cerebrovascular accident (CVA). After establishing the diagnosis of acute ischemic stroke
the electrocardiography (ECG) was advised and those subjects had abnormal findings on
ECG were went for echocardiography to evaluate the specific cause related to acute ischemic
stroke. The two-dimensional and M-mode echocardiography was performed by consultant
cardiologist had ≥ five years experienced in echocardiography because echocardiographic
study in patients with cerebrovascular accident (confirmed on CT scan) is evidence of potential
cardiac abnormalities as a predisposing cause for the vascular event. The data was collected
on pre-designed proforma and was analyzed in SPSS 16 and the frequency and percentage
was calculated. Results: Total one hundred patients with acute ischemic stroke were studied
for electrocardiographic and echocardiographic findings during six months study period. The
mean ±SD for age of patients with acute ischemic stroke was 43.67±10.62. Majority of the
patients were males and 69% while the age and gender cross tabulation was also statistically
significant (p=0.03). The electrocardiographic abnormalities were indentified in 80% patients
(AF in 16.2%, LVH in 22.5%, LBBB in 10%, wide QRS complex in 10% and ischemic changes
in 8.7%) while the echocardiographic abnormalities were detected in 70% patients of which
global hypokinesia (28.5%), LVH (25.7%) and diastolic dysfunction (17.14)% were predominant.
Conclusion: The cardiac embolic source is the major cause for acute ischemic stroke and
detected by echocardiography as it is the main tool in diagnosing the source of embolus.