Associated Cardiac Disorder in Patients with Cerebral Infarction. Analysis with Echocardiogram and Holter 24-Hour Electrocardiogram.:Analysis with Echocardiogram and Holter 24-Hour Electrocardiogram
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An analysis of cardiac disorders associated with acute brain infarction is reported. 174 patients were examined by means of echocardiography and/or Holter 24-hour electrocardiography (ECG). Based on mode of onset, infarctions were classified as sudden onset type and slowly progressive type, and based on the size and site, as large, cortical branch, perforator, cerebellar, and brain stem. Forty-four cases (25%) were of the sudden onset type and 130 (75%) of the slowly progressive type. Ninety-seven perforator area infarctions accounted for more than half of the total number of patients (56%). Echocardiographic findings; 158 patients were examined by echocardiography. Valvular disease, myocardial infarction, cardiomyopathy, enlarged left atrium, puffy "moyamoya" echo in the left atrium and ventricle, and left atrial thrombus, which are generally regarded as risk factors for cerebral embolism, were observed in 19 patients (43%) with the sudden onset type and in 17 patients (15%) with the slowly progressive type. There were significant differences between the two types. Findings within normal limits were seen in a total of 81 patients (51%). Holter 24-hour ECG findings; 104 patients were examined by Holter 24-hour ECG. Atrial fibrillation was observed significantly more often in the sudden onset type (9 patients, 32%) than in the slowly progressive type (7 patients, 9%), and significantly more often in infarction patients (16 patients of 104, 15%) than adults in general (0.4%). This examination contributed to the early diagnosis of sick sinus syndrome in one case. Normal findings were found in a total of 41 patients (39%). Summary; 1) Half of the patients with cerebral infarction had cardiac disorders based on echocardiographic and/or Holter 24-hour ECG findings regardless of type. 2) Evidence of valvular disease, myocardial infarction, cardiomyopathy, moyamoya echos in the left atrium and ventricle, or left atrial thrombi were observed significantly more often in the sudden onset type of cerebral brain infarction. 3) Atrial fibrillation was detected significantly more often in cerebral infarction patients and in the sudden onset type. In the acute stage of cerebral infarction, the possibility of complicating cardiac disorders should be taken into consideration and early diagnosis should be performed in order to improve treatment outcome and prevent recurrence of cerebral infarction.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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