Cardioembolic ischemic stroke in a group of young patients

Introduction. Among young patients cardioembolism is one of the most common causes of stroke. Aim. To identify the most common sources of cardioembolism for ischemic stroke in young patients. Materials and Methods. A retrospective study was carried out among 64 patients younger than 55 years old, who were hospitalized at Riga East Clinical University Hospital with a diagnosis of cardioembolic stroke. The frequency of cardioembolism sources were analyzed in patients of≤55, ≤49 and 50–55 years old. The causal relationship of the patent foramen ovale (PFO) to stroke was assessed using the Risk of Paradoxical Embolism (RoPE) Score. The data was analyzed using SPSS. Results. Patients younger than 55 years old: 32,8% had atrial fibrillation (AF), 20.3% – PFO, 15.6% – dilated cardiomyopathy, left ventricular hypertrophy, 7.8% – mechanical valves, 4.7% – left ventricular thrombus, atrial septal aneurysm with PFO, 3.1% – paroxysmal AF, recent myocardial infarction and left ventricular wall motionabnormalities, 1.6% – left atrial thrombus, left ventricular aneurysm without thrombus, congestive heart failure with EF <30%, apical akinesia and ventricular septal aneurysm. Comparing 2 age groups (≤49 years old (n = 31) and> 49 years old (n = 33)), PFO (41.9%) is the leading source of cardiac embolism in patients of ≤49 years old, in contrast, in patients of > 49 years old, the leading source of cardioembolism is AF – 54.6%, while no PFO is detected in any of the patients in this group. All patients with PFO on the RoPE score have a score of ≥7, indicating a high likelihood of stroke association with pathology. Conclusion. The most common source of cardioembolism in patients younger than 55 years old is AF. PFO plays a leading role in patients under 49 and AF – over 50 years old.