The relation of cardiac diseases to the early outcome of thrombolysis in patients with acute ischemic stroke / Nourhan Mohamed Mahmoud ; Supervised Nevin Mohi Eldin Shalaby , Sandra Mohamed Ahmed , Wael Mahmoud Ezzat Ibrahim

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neuropsychiatry

Background: Stroke is the second major cause of death and disability worldwide. It can be precipitated by various risk factors among which cardiac diseases play an important role. Atrial fibrillation (AF), heart failure (HF) and cardiomyopathy represent the commonest cardiac diseases precipitating for acute ischemic stroke(AIS) by different mechanisms such as being a potential source for embolic stroke or by causing cerebral hypoperfusion due to hemodynamic dysfunction. Objectives: To compare the clinical outcome in AIS patients with different cardiac diseases with non-cardiac patients after intravenous (IV) thrombolysis and to apply the role of transcranial ultrasonography (TCD) as a non-invasive method to detect recanalization in correlation with the clinical outcome. Methods: A cross-sectional study was performed at the stroke unit of Kasr Al-ainy Hospital of Cairo University in the period between January2020 till June 2020. All patients diagnosed with acute ischemic stroke who were eligible to receive IV thrombolysis were enrolled based on guidelines of the 2019 American Heart Association/American Stroke Association with total number of 42 patients. All received initial clinical assessment in the form of NIHSS before receiving IV thrombolysis and after 1 week.They were also assessed for their functional outcome after 3 months using the modified rankin scale (MRS). All of our 42 patients received plain CT brain, echocardiography and extracranial as well as transcranial ultrasonography that was done based on Cairo-University protocol. Results: There was significant difference between AIS patients with left ventricular regional wall motion abnormalities (LV RWMA{u2019}s) and those without LV RWMA regarding their NIHSS score after 1 week of IV thrombolysis and regarding MRS after 3 months. 42.9% showed poor clinical outcome among patients with LV RWMA{u2019}s while only 9.5% showed poor clinical outcome among those without LV RWMA{u2019}s

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