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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We believe there is a significant association between migraine and the prolapse mitral valve syndrome. Propranolol is the drug of choice in these patients for the treatment and prevention of migraine. Increased platelet aggregability may be the common pathophysiologic mechanism as relates to emboli from the valve and possibly in strokes related to migraine. Recognition of the association of the two syndromes will result in appropriate subacute bacterial endocarditis prophylaxis for patients at risk as well as prevention of improper medication to those patients with migraine who are at risk for stroke.
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PMID:Migraine and the mitral valve prolapse syndrome. 26 94

We evaluated 50 consecutive patients with acute ischemic stroke to assess the prevalence of systemic infection preceding the neurological event. We analyzed the immunohematologic characteristics of patients with and without signs and/or symptoms of a preceding infectious process. Patients were examined less than or equal to 7 days after cerebral infarction and evaluated for fibrinogen, anticardiolipin antibodies, fibrin D-dimer (a fragment of cross-linked fibrin), plasminogen activator inhibitor-1, and protein S. Of the 50 patients, 17 had symptoms of infection beginning less than or equal to 1 month before the stroke (11 had upper respiratory tract infections, three urinary tract infections, two subacute bacterial endocarditis, and one pneumonia). Compared with patients without infection, patients with infection had significant increases in fibrin D-dimer concentration (5.3 +/- 1.1 versus 4.7 +/- 0.9 log-transformed ng/ml, p less than 0.05) and cardiolipin immunoreactivity, IgG isotype (1.8 +/- 1.3 versus 1.1 +/- 0.9 log-transformed phospholipid units, p less than 0.04), and, when studied less than or equal to 2 days after the stroke, increased fibrinogen levels (459 +/- 126 versus 360 +/- 94 mg/dl, p less than 0.05). In conclusion, infection-associated cerebral infarction is common and is associated with substantial immunohematologic abnormalities.
Stroke 1991 Aug
PMID:Immunohematologic characteristics of infection-associated cerebral infarction. 148 66

We describe a man aged 42 years with mitral valve regurgitation who suffered from subacute bacterial endocarditis caused by Streptococcus morbillorum. The clinical picture began with a toxic syndrome. Five months later, the patient had an embolic episode and a right rostral pontine stroke, which was followed a few days later by an adversive focal seizure on the right. Despite antibiotic treatment, he suffered complete third nerve palsy. Arteriography, magnetic resonance imaging, and computed tomography of the brain showed a giant aneurysm in the rostral end of the basilar artery; the aneurysm was clipped. We discuss the clinical features, radiology, and characteristics of this aneurysm as a unique case of a giant bacterial aneurysm in the vertebrobasilar system.
Stroke 1990 Nov
PMID:Giant basilar aneurysm in the course of subacute bacterial endocarditis. 223 58

The effects of alcohol on the heart include modification of the risk of coronary artery disease, the development of alcoholic cardiomyopathy, exacerbation of conduction disorders, atrial and ventricular dysrhythmias, and an increased risk of hypertension, hemorrhagic stroke, infectious endocarditis, and fetal heart abnormalities.
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PMID:Cardiovascular effects of alcohol. 268 74

Thirty pediatric patients with isolated mitral valve prolapse were studied in order to elucidate the clinical manifestations and the natural history of this condition in children. The mean age at the time of diagnosis was 9.5 years, with a mean follow-up of 5 years. The evaluation of all 30 patients included: clinical examination by a pediatric cardiologist, ECG, chest X-ray, echocardiography and Holter monitoring. Two patients underwent cardiac catheterization and angiography, and two patients required antiarrhythmic medication for symptomatic ventricular tachycardia. No progression of mitral insufficiency was observed during the follow-up period. There were no instances of subacute bacterial endocarditis, cerebral vascular accident or sudden death. The prognosis of mitral valve prolapse appears to be favorable in childhood.
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PMID:Clinical spectrum and natural history of isolated mitral valve prolapse in 30 children. 646 72

Thirty-four patients with clinical infectious endocarditis were examined by M-mode and two-dimensional (2D) echocardiography. Vegetations were identified in 16 patients (47%) by M-mode and in 27 patients (87%) by 2D echocardiography. Vegetations identified by 2D echocardiography were categorized as small (less than 5 mm), medium (5 to 9 mm), or large (greater than or equal to 10 mm). Large vegetations were caused by a variety of organisms, had a higher incidence of surgery (44% v 0%), and had no increased incidence of stroke or death. The larger the vegetation, the more detectable it was by M-mode. Aortic valve vegetations were associated with a higher incidence of congestive heart failure (CHF) (67% v 14%) and stroke (44% v 9%). Four patients with large aortic valve vegetations had the highest complication rate; CHF developed in all four, two had valve replacement, one had a stroke, and two died.
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PMID:Clinical implications of large vegetations in infectious endocarditis. 662 71

A study was undertaken to compare the results of patient follow up done by mail and by telephone. Using valve follow up questionnaires recently received by mail, 100 patients were randomly selected from this group for further follow up by telephone. Interviews were conducted while blinded to the mail response. Patients were questioned as to their functional status (NYHA), improvement as a result of surgery (IMP), incidence of reoperation (REOP) or bacterial endocarditis (SBE) and thromboembolic complications (TE). They were also asked whether they would prefer future follow up by mail or telephone. Analysis using the kappa coefficient and McNemar's test revealed a difference (p < 0.001) in NYHA when comparing mail and telephone responses but no difference in either IMP or TE. There was no incidence of REOP or SBE. Sixty-six percent of patients had no preference in type of future follow up and of the remaining 33%, two-thirds preferred to be contacted by phone. It appears that NYHA is significantly overestimated by the patient whereas the two methods of follow up are comparable when assessing IMP and TE. It should be noted, however, that patients seem to have difficulty in identifying the occurrence of TE and in differentiating between stroke and TIA.
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PMID:Follow up of patients after valvular surgery: mail vs. telephone. 758 39

We report herein our experience with the Toronto Stentless Porcine Valve (Toronto SPV, manufactured by St. Jude Medical Inc., Minneapolis, MN, USA) for aortic valve replacement (AVR). To date 146 SPV valves have been implanted, 29 in an initial clinical trial (from October 1987 to April 1987) and 117 in the current FDA trial (September 1991 to January 1994). In the current trial the majority of patients were male (76%), aortic stenosis was the dominant lesion (73%) and 68% of the patients received a valve size 27 mm or greater. The mean age was 61.3 +/- 12.0 years. For the entire group there has been no hospital death and no patient has required a pacemaker. Perioperative complications were myocardial infarction in three patients and suspect subacute bacterial endocarditis (medically treated) in three patients. There have been two late deaths (2%), two patients have had transient ischemic attacks (2%), and one patient suffered stroke with complete neurological recovery (1%). To date there has been no case of primary valve failure. Echocardiographic assessment of the SPV valve has demonstrated excellent effective valve orifice areas with very low transvalvular gradients and 95% of the patients had either 0 or 1+ insufficiency. These results are encouraging and justify the continued use of this valve in clinical trials. Further follow-up is required to determine its durability.
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PMID:Stentless porcine bioprosthesis for aortic valve replacement. 777 20

A total of 103 patients (P) with infectious endocarditis (IE) were treated during the period 1982-1993; 72% of them were male. Mean age was 46.4 (SD 19.7). Eighteen patients were intravenous drug addicts (D) (17.5%). The first case of drug addiction in the IE group was seen in 1986; since then, there was a steady increase of this condition, reaching 50% of all cases. The average age of D patients was 28.17 +/- 8.15 years significantly lower than that corresponding to non-drug addicts (ND), 48.64 +/- 19.5 (p < 0.00001). The infection was located mainly in the left heart of the ND (93%), and in the right heart of the D (78%), the difference being statistically significant. All the cases of left IE occurred on previously damaged valves. Right location in ND was found in all cases in immunosuppressed individuals being treated for systemic diseases, except in one patient having an endocavitary pacemaker. No differences were found between ND and D with regard to the presence of fever, cutaneous manifestations, splenomegaly or cerebrovascular accident. Differences were noted, however, in the case of respiratory involvement, which showed a significantly higher frequency in D (38.9% versus 12.9%; p < 0.014). Blood cultures were positive in 81.6% of the total number of patients, no difference being found between the two groups. Staphylococcal infections were predominant in D (44%) and streptococcal infections in ND (48%), the difference being statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Infective endocarditis and drug addiction]. 785 83

Cardiac manifestations of phospholipid antibody syndrome may include mitral and/or aortic valve disease, pseudo-infectious endocarditis, thrombi of the right atrium, myocardial infection, pulmonary artery hypertension and cardiomyopathy with global or segmental left ventricular dysfunction. The authors report two patients showing evidence simultaneously of a circulating anticoagulant, dissociated syphilis serology and cardiolipin antibodies at a very high level. They had the majority of cardiac complications described in phospholipid antibody syndrome. Both also had renal involvement and one of them had recurrent venous thromboses and a cerebrovascular accident. Prolonged corticosteroid treatment, combined with anticoagulants in one patient, was accompanied by stability of lesions with follow-up of five years and ten months respectively.
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PMID:[Cardiac manifestations of phospholipid antibody syndrome. Study of 2 cases]. 811 52


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