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 HospitalDesign: Descriptive studySetting:  Srinagarind Hospital, Faculty of Medicine, Khon Kaen UniversityOne 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.