CEREBRAL EMBOLISM IN MITRAL STENOSIS

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Abstract
72 cases of mitral stenosis in which cerebral embolism occurred were studied. There were 26 [male] and 46 [female], the avg. age being 42.7 yrs. There were 24 immediate fatalities, i.e., 33% mortality. The avg. period of survival of the 15 patients who died subsequently was 13.2 mos. Analysis of the material revealed that hypertension had no effect on the immediate mortality, but the survival period of those who recovered was distinctly longer. Heart failure and auricular fibrillation were more common in the hypertensive group. Auricular fibrillation was present in 55 cases and regular rhythm in 17 cases. The immediate mortality and survival period of those recovering from embolism were not influenced materially by the presence of auricular fibrillation, despite the fact that hypertension and congestive failure were more common in this group. There were 23 cases with and 49 cases without congestive heart failure. The former had a much greater immediate mortality, especially when associated with regular rhythm. The prognosis for recovery of motor function after embolism was poor. Speech disturbance, however, cleared in practically all cases. The authors found that cerebral embolism was more likely to occur in cases of mitral stenosis who had very little objective evidence of congestive heart failure and was less apt to develop in those who were bed-ridden with advanced failure.

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