Cardiological pathology in patients with acute stroke: treatment and prevention of complications
Abstract
Acute stroke remains one of the main causes of death and disability. The incidence of acute stroke is similar to the incidence of acute coronary syndrome, but the prognosis for the patient who suffered stroke is significantly worse. More and more scientific evidence confirms that at least 30-50 % (possibly more depending on the diagnostic approach) of ischemic strokes are caused by cardiac pathology (atrial fibrillation, of valvular heart diseaseor congenital heart disease, infective endocarditis, etc.). An even greater number of patients have concomitant cardiac pathology, which, if not the cause, worsens the course and prognosis of a patient with acute stroke. Therefore, it is important and relevant to determine the characteristics of these patients, taking into account the characteristics of comorbid pathology. It is important to cooperate with doctors of different specialties.
In the acute period of stroke there are specific tacticsand treatment patients with concomitant hypertension, atrial fibrillation and other cardiac pathologies. The tactics of a cardiologist depends on the type of stroke – ischemic or hemorrhagic. In patients with a stroke, it is important to determine the etiologic factor. In the presence of cardiac pathology, which is the cause of embolism, using of anticoagulants is the prevention of repeated strokes. Therefore, effective diagnosis and treatment of heart disease can significantly contribute to both stroke prevention and its prognosis.
The article reviews the literature on the problem of treatment cardiopathology in patients who suffered a stroke or a transient ischemic attack. The peculiarities of the treatment of hypertension in the acute period of stroke and the post-stroke period are considered; questions of statinotherapy. The principles of the using (start, initiation) of oral anticoagulants in atrial fibrillation in patients with acute stroke are discussed. Principles of prevention of stroke in atrial fibrillation and «triple» therapy (double antiplatelet plus oral anticoagulant) are described.
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