[The contribution of systematic implementation of cardiovascular explorations for the detection of cardiac sources of embolism in patients with stroke: About 230 patients].

OBJECTIVES

Ischemic stroke are estimated at 80% of all strokes. Embolism of cardiac origin accounts for around 20% of them. The aim of our study is to report the contribution of cardiovascular investigations performed as a routine during the evaluation of patients with ischemic stroke.

PATIENTS AND

METHODS

This is a retrospective study of ischemic stroke cases collated in Cardiology department of the military hospital of Marrakech between January 2010 and December 2014. All our patients have systematically ECG, transthoracic echocardiography and Echo-Doppler ultrasound of the neck vessels while the transesophageal (TEE) echocardiography and Holter ECG was performed in some indications.

RESULTS

Two hundred and thirty patients were collected. The average age of patients was 66.3±12.5years with a male predominance in 64.2%. Eighty-five percent of patients had at least three cardiovascular risk factors. Hypertension (60.8%), diabetics (41.7%) and tobacco (33.3%). Cardiovascular history was noted in 30% of cases with 10% of dilated cardiomyopathy and 9.2% of ischemic stroke. Cardiovascular explorations led to the diagnosis of heart disease embolism in 32% and atherosclerosis of the neck vessels in 16%. The TEE performed in 8% of cases showed an emboligenic cause in 42% of them.

CONCLUSION

Cardiovascular explorations remain indispensable in the workup of all ischemic strokes even if their therapeutic effect is modest. The lacunar infarct out first at 34% followed by 32% of cardio embolic causes and atheroma of the neck vessels in approximately 16%.