A Clinical Study on Cerebral Embolism in Rheumatic Heart Disease

ABSTRACT

Cerbral embolism in the patient with rheumatic heart disease is a serious complication and has poor prognosis. In view of the abundance of rheumatic heart disease in Korea, a retrospective clinical study was done on 49 cases of cerebral embolism with rheumatic heart disease admitted to Severance Hospital from 1970 through 1977. The resultls were as follows; 1. The age distribution of the 49 patients ranged from 20 to 70 years and the mean age was 48.7 years. Twenty-five patients, more than half of the total number, were in their 5th and 6th decades, and the peak of the incidence was in the 6th decade. Male to female ratio was 11.3. 2. Mitral stenosis was by far the most predominant valvular lesion representing 33 of the 49 cases, and 25 of the 33 patients had "pure" mitral stenosis. Mitral valve involvement represented 43 of the 49 cases. 3. Seventeen of the total 49 cases were in regular sinus rhythm whereas 32 of the 49 were in atrial fibrillation at the time of admission. 4. Twenty-two of the 49 patients expired during the hospitalization whereas only six made complete recovery and the other 21 made variable degrees of recovery. The anticoagulant treatment did not appear to make any significant difference in the mortality probably due to inadequacy of timing, completeness and followup.