Transesophageal Echocardiography study in Ischemic Stroke

Aravind, C (2006) Transesophageal Echocardiography study in Ischemic Stroke. Masters thesis, Madurai Medical College, Madurai.

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Abstract

INTRODUCTION: Information about stroke reveal that even after detailed clinical history, physical examination and bio-chemical tests, available non-invasive techniques in the evaluation, 40% of patients with ischemic stroke (80% of all stroke victims) remain without clear identifiable cause. (2002 heart and stroke statistical update, American Heart Association). This group of patients was clubbed under a sub group called cryptogenic stroke. Evaluation of these patients with semi invasive techniques like transesophageal echocardiography revealed a lot of information into the insight of the etiology of stroke with this back ground, we studied patients with stroke and the utility of transesophageal echocardiography in identifying the cause of ischemic stroke in the so called cryptogenic stroke. AIM OF THE STUDY: Efficacy of transesophageal echocardiography in cryptogenic ischemic stroke. MATERIALS AND METHODS: Setting : Inpatient of Government Rajaji Hospital, Madurai. Design of study : Observational study. Period of study : One year from October 2004. Sample Size and Selection of study subjects : Fifty three CT Brain proved conscious ischemic stroke patients admitted in our department are included in this study. This study included 31male and 22 female patients. RESULTS: Among 53 ischemic stroke patients 11 had Rheumatic mitral stenosis with and without atrial fibrillation, 7 were female and mean age in the group was 30.1 + 6.2 years and 11 were categorized as cryptogenic ischemic stroke patient (without TEE) and 31 were categorized as other causes ie. having risk factors like diabetes, hypertension, ischemic heart disease and hypertropic cardiomyopathy. Among the Rheumatic mitral stenosis patients 4 had atrial fibrillation and 6 had left atrial thrombus Among the other causes patients, 5 were known case of diabetes, 18 were known case of hypertension and diabetes, 2 were known case of ischemic heart disease and 1 was hypertropic cardiomyopathy. Percentage of ischemic stroke patients with risk factors like diabetes, hypertension, Rheumatic heart disease, ischemic heart disease with LV dysfunction and hypertrophic cardiomyopathy was 79.3%. SUMMARY: Among 53 concious ischemic stroke patients 11 had Rheumatic mitral stenosis with and without atrial fibrillation and left atrial thrombus, 11 were categorized as cryptogenic ischemic stroke patients and 31 were categorized as other causes patients. All cryptogenic stroke patients were under 50 years, mean age was 38.5 years, None of the patient was smoker or alcoholic. In all cryptogenic patients lipid profile was normal and rapid test HIV was negative. Among the previously diagnosed as 11 cryptogenic stroke patients, 9 patients the cause was identified by TEE. In 2 patients the cause was undermined, so these patients should undergo further investigations like coagulation profile. Therefore transesophageal echocardiography play an important role in identifying the cause in patients who were previously diagnosed as cryptogenic ischemic stroke patients.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Ischemic Stroke ; Transesophageal Echocardiography study.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 15 Mar 2018 02:02
Last Modified: 15 Mar 2018 02:05
URI: http://repository-tnmgrmu.ac.in/id/eprint/6171

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