18100006008 THESIS

TITLE:

“ASSESSMENT OF LEFT VENTRICULAR FUNCTION IN ISCHEMIC STROKE

INTRODUCTION:

Heart disease is a major risk factor for stroke, ranking third after age and hypertension1. 

Congestive Cardiac failure ranks second in cardiogenic stroke risk1 with a two to three fold relative risk1,2

Heart failure is a progressive and debilitating disease, is increasing in epidemic proportions and affecting both the developed and the developing world3,4.

Heart failure is associated with shorter life expectency, increased frequency of hospitalization and poor quality of life, and is a major public health challenge even in India5-8.

In order to reduce the complications of heart failure it is essential to diagnose and treat pre symptomatic left ventricular dysfunction (LVD).We focus on a new way to screen for asymptomatic LVD which is likely to be cost-effective.

LVD is a treatable condition, which accounting for 8% of people aged 25–75 years, 12% of 45-75 years old. Of the 8%, 4% are asymptomatic9.

The patients who appear to be at high risk of LVD are those with ischemic heart disease, hypertension or diabetes, and smokers10-12 But, the echocardiographic screening of all these patients for left ventricular dysfunction is a costly process. So, one can screen the patients who have their first vascular episode. 

The first vascular episode could be either a myocardial infarction (MI), a transient ischemic attack (TIA), a cerebrovascular accident (CVA) or peripheral vascular disease.

In most of TIA/CVA/PVD patients, the cause of death is a cardiac problem. So, screening of these patients with ECG and echo after their first vascular episode could be helpful to identify the underlying cardiac issue like LVD. So that one can treat it, and reduce the subsequent overt heart failure and even sudden cardiac death.

So, in this study, I have tried to assess left ventricular(LV) function in patients, presented with ischemic stroke.

AIMS AND OBJECTIVES:

To study left ventricular function in ischemic stroke patients by electrocardiogram

(ECG) and echocardiogram (2D ECHO).

PATIENTS AND METHODS:

STUDY DESIGN: Cross sectional study.

STUDY SETTING: All patients admitted with ischemic stroke in Department of

General Medicine, Kamineni Institute of Medical Sciences, Narketpally.

STUDY SAMPLE: 100 patients with ischemic stroke.

PERIOD OF STUDY: 2 years from October 2018 to September 2020.

INCLUSION CRITERIA:

• Age more than 40 yrs

• Patients diagnosed with ischemic stroke by using CT/MRI BRAIN screening.

EXCLUSION CRITERIA:

• Patients under the age of 40 yrs will be excluded from the study group.

• Patients with haemorrhagic stroke will be excluded from the study group

METHODOLOGY

• ECG, 2D-ECHO, CT/MRI BRAIN will be performed in all study patients.

• Repeat CT/MRI brain after 48hrs if initial scan is normal.

INVESTIGATIONS:

• Complete blood picture

• Complete urine examination

• Blood urea, Serum creatinine, serum electrolytes

• Fasting lipid profile

• Carotid Doppler

• Chest X-ray.

• ECG

• 2D-ECHO

• CT/MRI BRAIN

MASTER CHART:

https://docs.google.com/spreadsheets/d/16D3SIbC7UPjbRiZt2Y9538xgzSCcQq5E/edit?usp=drivesdk&ouid=108872713690900170464&rtpof=true&sd=true

LINK TO COMPLETE THESIS WITH MASTER CHART:

https://drive.google.com/file/d/169kfAxkum1-sg0u4Gnh2aPBTO7N6Qpem/view?usp=drivesdk