[Rheumatic heart disease: cause of cerebrovascular disease at the National Institute of Cardiology "Ignacio Chávez"].

OBJECTIVE

To review the epidemiological profile of stroke associated to rheumatic heart disease (RHD) in a Mexican Cardiovascular Center. Cardioembolic stroke is one of the most severe causes of death and disability and the spectrum of its neurological complications is diverse.

PATIENTS AND

METHODS

This is a 10-years retrospective study of 709 patients with stroke diagnosis from the National Institute of Cardiology "Ignacio Chávez" Stroke Data Bank from 1991 to 2000. Derived from this information, only the cases with RHD were selected along with those with a perfectly defined profile for cardioembolic mechanism, according to the Cerebral Embolism Task Force on Cardiogenic Brain Embolism.

RESULTS

We selected 250 stroke patients; 163 of these cases (65.2%) presented cardioembolism criteria. This association was more frequent in women (126/77.3%) than in men (37/22.7%). Average age was of 50 years. The damage to valves in RHD was: DML with predominance of stenosis, 88/54%; MI, 56/34.3%; AVL, 19/11.7%. Atrial fibrillation was the most commonly associated arrhythmia. The presence of mechanical prosthetic mitral valves was of 59/36.19%. Sensor-motor syndrome and language disorders were the most common clinical neurological consequences.

CONCLUSIONS

In our country, RHD continues being one of the most frequent causes of severe disability, specially when is associated to strokes in young people.