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Detecting the etiology of a stroke through a cardiological examination

Oct 10, 2023

How a specialized cardiac examination can detect the cause of stroke – Case report.

She writes:

Penelope Rafoulis-Stergiou, MD, PhD

Director of the Cardiology Department

Therapis General Hospital

Vascular Stroke (CVA) is the 3η cause of death worldwide, after heart disease and cancer, and the most common cause of permanent disability. Over 700.000 TBIs/year are recorded in the US, with approximately 150.000 deaths.

There are two types of AEE: Bloody and  Ischemic. The second and more common type is caused by reduced blood supply to an area of ​​the brain due to blockage of the artery that supplies it.

This is usually due to clot displacement either from the heart (as in cases of atrial fibrillation) or from the venous network if there is some type of communication between the right and left chambers of the heart (paradoxical embolism).

 

 

 

A 72-year-old man admitted to our hospital for a new ischemic stroke with a history of multiple previous ones (at least 5) underwent transesophageal echocardiogram with intoxication in the context of investigating their etiology.

There, the existence of inter-atrial communication, i.e., the presence of pathological blood flow between the left and right atria, was established, which could justify the occurrence of AEs through the mechanism of paradoxical embolism.

 

Closure of the communication, either invasively or surgically, is recommended in these patients to prevent new strokes and the development of cardiac complications such as heart failure and atrial fibrillation.

 

The Cardiology Department of Therapis General Hospital has state-of-the-art equipment, including the latest generation ultrasound Acuson SC2000, for the execution of simple heart triplex. It also offers newer specialized ultrasound techniques, such as stress echo (dynamic heart ultrasound), transesophageal echocardiogram, and myocardial strain study.

All tests are carried out by a specialized team with absolute security.

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