Advertisement
 

doctorslounge.com

 
Powered by
Careerbuilder

 

                    Home  |  Forums  |  Humor  |  Advertising  |  Contact
   Ask a Doctor

   News via RSS

   Newsletter

   Home

   News

   Conferences

   CME

   Forum Archives

   Diseases

   Symptoms

   Labs

   Procedures

   Drugs

   Links
   Specialties

   Cardiology

   Dermatology

   Endocrinology

   Fertility

   Gastroenterology

   Gynecology

   Hematology

   Infections

   Nephrology

   Neurology

   Oncology

   Orthopedics

   Pediatrics

   Pharmacy

   Primary Care

   Psychiatry

   Pulmonology

   Rheumatology

   Surgery

   Urology

   Other Sections

   Membership

   Research Tools

   Medical Tutorials

   Medical Software

 

 Headlines:

 
 

Back to table of contents

Cerebrovascular disease and risk of stroke

Submitted by Dr. Yasser Mokhtar, MD. Dept. of internal medicine. School of medicine, University of South Dakota.

 

Stroke is a loss of cerebral function with symptoms lasting >24 hrs or death due to vascular disease

 
 

tellfrnd.gif (30x26 -- 1330 bytes)send to a friend
 
prntfrnd.gif (30x26 -- 1309 bytes)printer friendly version
 
 
 
  Related
 
  Cerebral circulation
The internal Medicine Lounge
 
   
 

2. Cardiac diseases

Cardiac diseases have been clearly associated with an increased risk of ischemic stroke particularly atrial fibrillation, valvular heart disease, myocardial infarction, coronary artery disease, congestive heart failure, electrocardiographic evidence of left ventricular hypertrophy and perhaps mitral valve prolapse.

Atrial fibrillation (AF)

This is the most potential cardiac source of embolism to the brain. AF is usually non-rheumatic in developed countries. Both non-rheumatic and more so rheumatic AF have been associated with stroke from postmortem (Hinton et al., 1977) case control (Kempster et al., 1988) and cohort studies (Flegel et al., 1987). AF even without valvular heart disease is strongly correlated with stroke, especially embolic stroke (Wolf et al., 1983). AF prevalence is very closely related to age so that most strokes caused by AF are in the very elderly, where the proportion attributed to AF is highest (Wolf et al., 1991). Some of the association must be coincidental because AF can be caused by coronary heart disease and hypertensive heart disease both of which may be associated with stroke by mechanisms other than embolism from the fibrillating left atrium (Davies et al., 1987). In the Framingham study, AF was a strong predictor of stroke with nearly a five-fold increased risk of stroke. In those with coronary heart disease, or cardiac failure, AF doubled the stroke risk in males and tripled the risk in females. With coexisting valvular disease, AF had an even greater impact on the relative risk of stroke. Left ventricular dysfunction and left atrial size determined by echocardiography were also predictors of increased thromboembolic risk (Wolf et al., 1991). 

Coronary artery disease

Independent of age coronary artery disease (myocardial infarction or angina) is clearly associated with stroke. The evidence comes from postmortem (Stemmerman et al., 1984), case control (Woo et al., 1991), and cohort studies (Kannel et al., 1983). Data suggest that most of this association is causal (i.e. embolism from the left ventricular thrombus complicating myocardial infarction) rather than due to the coincidence of atheroma in coronary and cerebral circulation in the same (predisposed) individuals (Dexter et al., 1987).

Cardiac failure is a further risk factor (Kannel et al., 1983).

ECG abnormalities reflecting hypertension or coronary heart disease are, not surprisingly, risk factors for stroke (Knutsen et al., 1988 and Shaper et al., 1991).

advertisement.gif (61x7 -- 0 bytes)
 

Are you a doctor or a nurse?

Do you want to join the Doctors Lounge online medical community?

Participate in editorial activities (publish, peer review, edit) and give a helping hand to the largest online community of patients.

Click on the link below to see the requirements:

Doctors Lounge Membership Application


previous.gif (72x17 -- 347 bytes)

next.gif (72x17 -- 277 bytes)

 

 advertisement.gif (61x7 -- 0 bytes)

 

 



We subscribe to the HONcode principles of the HON Foundation. Click to verify.
We subscribe to the HONcode principles. Verify here

Privacy Statement | Terms & Conditions | Editorial Board | About us
Copyright 2001-2012 DoctorsLounge. All rights reserved.