Etiological spectrum of cardioembolic strokes in a tertiary care hospital of India: Analysis of one year data

Gudapati MK, Sirisha S, Patil A, Manukinda J, Yada PK, Jayalakshmi S, Varalakshmi EA, Kaul S, Surath M

Pdf Page Numbers :- 118-122

Mahathi Krishna Gudapati¹, Sai Sirisha¹, Anuja Patil¹, Jayasree Manukinda¹, Praveen Kumar Yada¹, Sita Jayalakshmi¹, Varalakshmi EA¹, Subhash Kaul^1,*, and Mohandas Surath¹

¹Department of Neurology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India

*Corresponding author: Dr. Subhash Kaul, Sr. Consultant Neurologist, Department of Neurology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India. Email: subashkaul@hotmail.com

Received 11 May 2022; Revised 13 June 2022; Accepted 21 June 2022; Published 30 June 2022

Citation: Gudapati MK, Sirisha S, Patil A, Manukinda J, Yada PK, Jayalakshmi S, Varalakshmi EA, Kaul S, Surath M. Etiological spectrum of cardioembolic strokes in a tertiary care hospital of India: Analysis of one year data. J Med Sci Res. 2022; 10(3):118-122. DOI: http://dx.doi.org/10.17727/JMSR.2022/10-22

Copyright: © 2022 Gudapati MK et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: Traditionally rheumatic heart disease with mitral stenosis and atrial fibrillation has been the common mechanism of cardioembolic strokes in India. However, with the increase in life span and higher detection and development of cardiac diseases, the frequency and etiologic spectrum of cardioembolic stroke in an Indian hospital may be changing.

Methods: The case records of patients admitted in the year 2020 were analyzed for the presence of risk factors and identified stroke mechanisms.

Results: Among 538 patients of ischemic strokes, cardioembolic source was identified in 156 (29.8%) patients. Five major cardiac sources of embolism were identified: Coronary artery disease (with acute or remote myocardial infarction) 56/156 (35.89%), non valvular atrial fibrillation, 34/156(21.79%), post cardiac intervention 28/156 (17.94%), left atrial cardiomyopathy 20/156 (12.8%), and rheumatic heart disease 13/156 (8.3%).

Conclusion: Coronary artery disease, non valvular atrial fibrillation, post intervention stroke and left atrial cardiomyopathy are emerging as common causes of cardioembolic strokes. Rheumatic heart disease continues to be an important but less frequent cause of cardioembolic strokes.

Keywords: cardioembolic strokes; rheumatic heart disease; etiological spectrum; India