Spectrum of Cardiac Etiologies and Associated Risk Factors in Cardioembolic Ischemic Stroke: A Prospective Observational Study

Abstract

Background:

Ischemic stroke is one of the leading causes of morbidity and mortality. There are several cardiac issues associated with the thromboembolic phenomenon resulting in ischemic stroke that are linked with a number of risk factors which can be prevented via early diagnosis and prompt management.

Objective:

The primary objective of this study is to evaluate the spectrum of cardiac etiologies responsible for the incidence of cardioembolic ischemic stroke. The secondary objective is to quantify the risk factors associated with these cardiac etiologies.

Study Design:

A prospective observational study was conducted at a tertiary care hospital from January 2020 to January 2023. A convenience sample of 190 patients who met the inclusion criteria were enrolled in the study.

Results:

Majority of the patients were male n=107, 56%, presented within first 6 hours of onset of stroke symptoms n=63, 33%, p value <0.01, involving posterior circulation n=71, 37%. The most prevalent symptoms were headache 91%, dysarthria 54%, dizziness 51%, and altered sensorium 45%. Atherosclerosis 91%, dyslipidemia 85%, hypertension 77%, and diabetes 53.6% were the most common presenting complaints. Out of 190 patients, 115 patients were diagnosed and 75 were undiagnosed cases of cardiac dysfunction. Dilated cardiomyopathy 43.6%, recent myocardial infarction 15.7%, and regional ventricular akinesis 11.5%.

Conclusion:

Cardiac evaluation after ischemic stroke is crucial to identify the potential cause of stroke as well as to rule out cardiac thromboembolic phenomenon. There are multiple risk factors associated with cardioembolic ischemic stroke which require effective control and management to prevent morbidity and mortality.

Keywords:

thromboembolism, ischemic stroke, cardiac manifestations, risk factors, epidemiology