RT Journal Article
SR Electronic
T1 Proportion of acute ischaemic strokes attributable to a cardiac aetiology in an unselected young patient population: A single centre experience
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 174
OP 177
DO 10.7861/clinmed.2019-0353
VO 20
IS 2
A1 Rahul Bahl
A1 Magdalena Kubiak
A1 Syarah Yusoff
A1 Hsiu Tung
A1 James Stirrup
A1 André van Wyk
A1 Kiruba Nagaratnam
A1 Neil Ruparelia
YR 2020
UL http://www.rcpjournals.org/content/20/2/174.abstract
AB The incidence of acute ischaemic stroke in young patients is increasing and identifying the underlying cause is critically important with regards to their optimal management. The true proportion of cardiac causes of stroke in young patients is poorly defined. We aimed to determine the proportion of strokes attributable to cardiac causes in an unselected, consecutive cohort of young patients. We used the database of a large stroke service to identify patients aged ≤55 years presenting with stroke between 01 January 2015 and 31 December 2017. We reviewed their clinical notes and investigations and then categorised patients by the cause of their stroke.We screened 202 cases, and excluded 35, resulting in a study population of 167 patients; 24.0% (40/167) had a cardiac cause of stroke including 9.6% (16/167) had patent foramen ovale, 9.0% (15/167) had intracardiac source of embolus and 5.4% (9/167) had atrial fibrillation; 50.8% (85/167) had other more likely causes; and 25.1% (42/167) had no clear underlying cause.A high proportion (24%) of strokes in young patients are secondary to a cardiac cause. Thorough investigation in these patients is warranted and requires close interdisciplinary links between cardiologists and stroke physicians to ensure optimal management.