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Abstract Details

Evaluating the Utility of Echocardiogram in the Diagnostic Workup of Stroke Patients in Resource-limited Settings
Cerebrovascular Disease and Interventional Neurology
P5 - Poster Session 5 (11:45 AM-12:45 PM)
4-013

 We evaluated how often echocardiogram detected a potential cardiac source of embolism (CSE) in adults with acute ischemic stroke in Zambia.

Echocardiography is recommended in ischemic stroke work-up, yet its value in resource-limited settings ,where access is constrained, remains unclear.

A prospective cohort study was conducted from December 2019 to November 2024 at the University Teaching Hospital in Lusaka, Zambia, which enrolled patients with acute stroke. Data on medical history, diagnostic results, and treatment were collected. We calculated the proportion of patients with potential CSE on echocardiography, which was only obtained in those who could pay for this investigation.

Among 863 participants (mean age 60 ± 16 years; 465 [54%] female), 475 (55%) had ischemic stroke, 278 (32%) hemorrhagic stroke, and 110 (13%) unknown stroke type (i.e. no neuroimaging obtained). Echocardiograms were completed in 311 participants (36%), 208 of which were in participants with ischemic stroke. Among participants with ischemic stroke, potential CSEs were detected in 46 participants (22%): Ejection Fraction < 40% (n=35), atrial fibrillation (n=5), valvular heart disease (n=4), and thrombus/vegetation (n=2).

In this cohort, echocardiography detected a potential CSE in nearly one quarter of patients with ischemic stroke who obtained the test. Given the potential of CSE to change both acute management and long-term secondary prevention regimens, echocardiography is a potentially useful investigation in this setting. Efforts to improve access, including potentially bedside echocardiography, are needed to improve short- and long-term outcomes for people with ischemic strokes in this setting.
Authors/Disclosures
William Tembo, MD
PRESENTER 		An immediate family member of Mr. Tembo has received research support from City University of New York (CUNY).
Madalitso Nthere, MBBS Dr. Nthere has nothing to disclose.
Gabriel Sneh, MD (Johns Hopkins) Dr. Sneh has nothing to disclose.
Ndonji Chiwaya, MD Ndonji Chiwaya has nothing to disclose.
Melody T. Asukile, MBBS (University Teaching Hospital) Dr. Asukile has received research support from Royal Society for Tropical Medicine and Hygiene. The institution of Dr. Asukile has received research support from Leverhulme Trust. Dr. Asukile has received personal compensation in the range of $0-$499 for serving as a meeting speaker with American Neurological Association.
Sarah Braun, MD (University Teaching Hospital, Lusaka, Zambia) Sarah Braun has nothing to disclose.
Diwell Mwansa (UNZA Ridgeway campus) Diwell Mwansa has nothing to disclose.
Lorraine Chishimba, MBChB, MMED (University Teaching Hospital) Dr. Chishimba has nothing to disclose.
Mashina Chomba, MBChB (University of Zambia) Dr. Chomba has nothing to disclose.
Emmanuel Mukambo, MD Dr. Mukambo has nothing to disclose.
Taonga Msimuko, MD The institution of an immediate family member of Dr. Msimuko has received research support from Africa Development Bank.
Theresa Shankanga (University of Zambia, ridgeway campus) Miss Shankanga has nothing to disclose.
Leroy Yankae, MD Leroy Yankae has nothing to disclose.
Stanley Zimba, MBBS (University Teaching Hospital) Dr. Zimba has nothing to disclose.
Musisye Luchembe Musisye Luchembe has nothing to disclose.
Coolwe Namangala Dr. Namangala has nothing to disclose.
Mulenga Chilando (University Teaching Hospital) Mulenga Chilando has nothing to disclose.
Julia Mwamba (University Teaching Hopsital) Julia Mwamba has nothing to disclose.
Michael Kinkata, MD Michael Kinkata, MD has nothing to disclose.
Deanna Saylor, MD, MHS (Johns Hopkins Hospital) Dr. Saylor has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生. The institution of Dr. Saylor has received research support from National Institutes of Health. The institution of Dr. Saylor has received research support from 好色先生. Dr. Saylor has a non-compensated relationship as a Member of multiple committees and task forces focused on improving access to MS medications to people across the world with Multiple Sclerosis International Federation that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the Neurology and COVID19 committee with World Health Organization that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the International Outreach Committee, Junior and Early Career Membership Committee, and 好色先生al Innovation Commitees with American Neurological Association that is relevant to AAN interests or activities.