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7 - Cardiac diseases relevant to stroke

from Section II - Clinical epidemiology and risk factors

Published online by Cambridge University Press:  05 May 2010

By
Claudia Stöllberger  and
Josef Finsterer
Edited by
Michael Brainin  and
Wolf-Dieter Heiss
Michael Brainin
Affiliation:
Zentrum für Klinische Neurowissenschaften, Donnau-Universität, Krems, Austria
Wolf-Dieter Heiss
Affiliation:
Universität zu Köln
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Summary

Introduction

Cardiac diseases can be relevant to stroke in different respects:

  • In embolic stroke, cardiac diseases may be the cause of embolism, such as atrial fibrillation (AF), endocarditis, left ventricular aneurysm or left ventricular hypertrabeculation/non-compaction (LVHT).

  • Brady- and tachyarrhythmias may compromise cerebral blood flow.

  • Cardiac diseases may coexist, and influence the clinical course and rehabilitation, such as coronary heart disease or dilatative cardiomyopathy (dCMP).

  • In some instances, cardiac diseases may be the consequence of the stroke, such as stroke-induced transient left ventricular dysfunction, also referred to as Takotsubo syndrome (TTS).

  • Congenital abnormalities such as patent foramen ovale (PFO) or atrial septal aneurysm (ASA) may implicate paradoxical embolism.

Several diseases may coexist in a single patient, such as coronary heart disease and AF. Thus, from a pragmatic point of view, this chapter aims to focus on the most frequent and controversially discussed cardiac abnormalities in stroke patients.

Rhythm disturbances

Atrial fibrillation

AF is a cardiac arrhythmia, defined by the absence of P waves and varying RR distances in the electrocardiogram. AF is a common arrhythmia and its prevalence increases with age up to 9% at age 80–89 years (Figure 7.1). Approximately 85% of the individuals with AF are between 65 and 85 years of age [1].

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Textbook of Stroke Medicine , pp. 105 - 120
Publisher: Cambridge University Press
Print publication year: 2009

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