Cardiopatía reumática: causa de enfermedad vascular cerebral en el Instituto Nacional de Cardiología [quot ]Ignacio Chávez[quot ] / Rheumatic heart disease: cause of cerebrovascular disease at the National Institute of Cardiology [quot ]Ignacio Chávez[quot ]

ABSTRACT

OBJECTIVE: To review the epidemiological profile of stroke associated to rheumatic heart disease (RHD) in a Mexican Cardiovascular Center. Cardioembolic stroke is one of the most severe causes of death and disability and the spectrum of its neurological complications is diverse. PATIENTS AND METHODS: This is a 10-years retrospective study of 709 patients with stroke diagnosis from the National Institute of Cardiology [quot ]Ignacio Chávez[quot ] Stroke Data Bank from 1991 to 2000. Derived from this information, only the cases with RHD were selected along with those with a perfectly defined profile for cardioembolic mechanism, according to the Cerebral Embolism Task Force on Cardiogenic Brain Embolism. RESULTS: We selected 250 stroke patients; 163 of these cases (65.2%) presented cardioembolism criteria. This association was more frequent in women (126/77.3%) than in men (37/22.7%). Average age was of 50 years. The damage to valves in RHD was DML with predominance of stenosis, 88/54%; MI, 56/34.3%; AVL, 19/11.7%. Atrial fibrillation was the most commonly associated arrhythmia. The presence of mechanical prosthetic mitral valves was of 59/36.19%. Sensor-motor syndrome and language disorders were the most common clinical neurological consequences. CONCLUSIONS: In our country, RHD continues being one of the most frequent causes of severe disability, specially when is associated to strokes in young people.