Atrial fibrillation Prevent stroke, stop symptoms

You expected to sail through your yearly check-up. What you didn't expect was a diagnosis of a heart rhythm problem called atrial fibrillation.

Atrial fibrillation occurs in about 1 percent of adults in their 60s. The incidence rate rises with age after that, with about 10 to 12 percent of people in their 80s having atrial fibrillation.

Atrial fibrillation may or may not cause symptoms. Either way, it can lead to development of blood clots in the heart that can break off and travel to the brain, where they can disrupt blood supply and cause a stroke.

About 15 percent of strokes are attributed to atrial fibrillation — and that number may be higher as undetected atrial fibrillation may be responsible for some of the roughly 25 percent of strokes that have no identifiable cause.

Whether you feel symptoms or not, it's important to follow through with recommended treatments. These may include medications or surgery designed to help control or reset your heart rhythm, in addition to anti-clotting medications to prevent stroke.

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Smokers Unaware of Tobacco's Impact on Heart, Stroke Risk

By Shelley Wood

April 20, 2012 (Dubai, United Arab Emirates) — An international study is confirming what many cardiologists have known for a while--many smokers around the globe know that smoking can cause lung cancer, but far fewer are aware that their habit has adverse effects on the heart. Even more striking, smokers were largely unaware that secondhand smoke increases the risk of heart disease and stroke among nonsmokers.

The new numbers, unveiled by Dr Geoffrey T Fong (University of Waterloo, ON) at the World Congress of Cardiology (WCC) 2012, come from the International Tobacco Control (ITC) Policy Evaluation and the Global Tobacco Surveillance System (GTSS). Both, Fong noted to heartwire , provide strikingly similar snapshots of smokers' perceptions of their own disease risk.

"We know the science--that smoking or tobacco use and secondhand smoke are significant causes of CVD, as well as lung cancer and other forms of cancer--and then the question becomes, do people know the facts about the relationship between tobacco use, secondhand smoke, and CVD, and to what extent does this differ across different countries?" Fong told heartwire . "This is important because well-informed people are more capable of making a decision about tobacco use: for those who don't use it, will they start? or for those who are using tobacco, would it give them reason to quit?"

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MRI Guides Diagnostic Approach for Ischaemic Stroke

M A Kumar; H Vangala; D C Tong; D M Campbell; A Balgude; I Eyngorn; A S Beraud; J M Olivot; A W Hsia; R A Bernstein; C A Wijman; M G Lansberg; M Mlynash; S Hamilton; M E Moseley; G W Albers

Background and aim Identification of ischaemic stroke subtype currently relies on clinical evaluation supported by various diagnostic studies. The authors sought to determine whether specific diffusion-weighted MRI (DWI) patterns could reliably guide the subsequent work-up for patients presenting with acute ischaemic stroke symptoms.
Methods 273 consecutive patients with acute ischaemic stroke symptoms were enrolled in this prospective, observational, single-centre NIH-sponsored study. Electrocardiogram, non-contrast head CT, brain MRI, head and neck magnetic resonance angiography (MRA) and transoesophageal echocardiography were performed in this prespecified order. Stroke neurologists determined TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification on admission and on discharge. Initial TOAST stroke subtypes were compared with the final TOAST subtype. If the final subtype differed from the initial assessment, the diagnostic test deemed the principal determinant of change was recorded. These principal determinants of change were compared between a CT-based and an MRI-based classification schema.
Results Among patients with a thromboembolic DWI pattern, transoesophageal echocardiography was the principal determinant of diagnostic change in 8.8% versus 0% for the small vessel group and 1.7% for the other group (p<0.01). Among patients with the combination of a thromboembolic pattern on MRI and a negative cervical MRA, transoesophageal echocardiography led to a change in diagnosis in 12.1%. There was no significant difference between groups using a CT-based scheme.
Conclusions DWI patterns appear to predict stroke aetiologies better than conventional methods. The study data suggest an MRI-based diagnostic algorithm that can potentially obviate the need for echocardiography in one-third of stroke patients and may limit the number of secondary extracranial vascular imaging studies to approximately 10%.

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