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Hidden Disease in Stroke Patients

The American Heart Association recommends doctors now examine stroke patients for the presence of heart disease, even though they may not be showing symptoms. //A new study shows up to 40 percent of patients with mini-strokes have undetected heart disease.

Heart disease and stroke both result from vascular disease where blood flow to the heart or brain is affected. The researchers say the link between the diseases can be found in the large vessels leading to the brain. They also note the risk of heart attack or sudden cardiac death is higher over time than it is short-term.

The studies, led by researchers at the Medical College of Georgia in Augusta, indicate this healthy patient group needs to be given noninvasive tests to detect the presence of heart disease. Currently, there are no guidelines for doctors to manage heart disease in otherwise healthy patients, who are showing no signs of the disease.

The study authors say when it is not obvious whether a stroke was caused by large or small vessel disease, doctors should evaluate whether the patient is at risk of a heart attack by looking at their age, gender, cholesterol and blood pressure levels, smoking history and diabetes risk. The American Heart Association suggests patients whose risk is 20 percent or higher should undergo further medical testing. The authors write: "Several testing options are available for stroke patients who are being evaluated for unrecognized coronary artery disease. The most commonly used tests for myocardial ischemia are exercise ECG, nuclear myocardial perfusion imaging, and stress echocardiography."

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