Revision of Echocardiographic Indications and Findings in Neurologically Ill Patients



Claudia Stöllberger1, *, Christian Wegner2, Josef Finsterer1
1 Krankenanstalt Rudolfstiftung, Juchgasse 25, 1030 Wien, Austria
2 Vienna Institute of Demography of the Austrian Academy of Sciences, Welthandelsplatz 2, Level 2, 1020 Wien, Austria


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© Stöllberger et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Steingasse 31/18, A-1030 Wien, Österreich, Tel: +43 676 403 11 87; Fax: +43 171 165 22 09; E-mail: claudia.stoellberger@chello.at, fifigs1@yahoo.de


Abstract

Background and Objective:

Little is known about the general indications for echocardiography and the prevalence of abnormalities detected by echocardiography in patients who are referred from a neurological department. Left ventricular hypertrabeculation/noncompaction (LVHT) is associated with neuromuscular disorders and embolism. The aim of the study was to assess the indications for echocardiography in patients from a neurological department and to review the cine-loops of the examinations in order to assess the frequency of abnormal echocardiographic findings with special regard to LVHT.

Methods and Results:

Included were 126 patients, 58 females (mean age 65 years). Indications were stroke (84%), heart failure (6%), endocarditis (6%) and arrhythmia (3%). The most frequent abnormalities were impaired relaxation (71%) and left ventricular wall thickening (63%). Females were older (68 vs. 62 years, p = 0.0214) and more frequently had normally sized left ventricles than males (98 vs. 88%, p = 0.0376). Patients ≥66 years more frequently had stroke as an indication (91 vs. 77%, p = 0.05), showed a thickened myocardium (72 vs. 53%, p = 0.0272), valvular abnormalities (52 vs. 13%, p = 0.0000) and impaired relaxation (86 vs. 54%, p = 0.0001) than patients <66 years.

LVHT was diagnosed in 3 patients; in one of them the diagnosis was already known. In 45% LVHT and in 38% left ventricular thrombus could neither be excluded nor established since the image quality was poor.

Conclusion:

Care should be taken to visualize the left ventricular apical regions when investigating patients referred from a neurologic department in order not to overlook LVHT and thrombi within the left ventricular apex.

Keywords: Echocardiography, Stroke, Neuromuscular disorders, Cardiomyopathy.