Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1974 Apr;37(4):378–383. doi: 10.1136/jnnp.37.4.378

Cerebral embolism and mitral stenosis: survival with and without anticoagulants

G F Adams 1,2, J D Merrett 1,2, W M Hutchinson 1,2, A M Pollock 1,2
PMCID: PMC494667  PMID: 4838909

Abstract

Eighty-four patients with mitral stenosis and cerebral embolism have been followed up for 20 years. Half of the series (those treated in the early years) had no anticoagulant treatment and half were given long-term warfarin therapy. Mortality rate and causes of death have been reviewed, and comparison of survival times of treated and untreated groups by life-table analysis bears out the immediate need for anticoagulants when a diagnosis of systemic embolism is established. It is wise to continue the treatment for six months but it may be reasonable to discontinue it after one year with patients who can be assured of regular review.

Full text

PDF
378

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ADAMS G. F., MERRETT J. D. Prognosis and survival in the aftermath of hemiplegia. Br Med J. 1961 Feb 4;1(5222):309–314. doi: 10.1136/bmj.1.5222.309. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. ADAMS G. F. PROSPECTS FOR PATIENTS WITH STROKES, WITH SPECIAL REFERENCE TO THE HYPERTENSIVE HEMIPLEGIC. Br Med J. 1965 Jul 31;2(5456):253–259. doi: 10.1136/bmj.2.5456.253. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. ASKEY J. M., CHERRY C. B. Thromboembolism associated with auricular fibrillation; continuous anticoagulant therapy. J Am Med Assoc. 1950 Sep 9;144(2):97–100. doi: 10.1001/jama.1950.02920020017005. [DOI] [PubMed] [Google Scholar]
  4. BERKSON J., GAGE R. P. Calculation of survival rates for cancer. Proc Staff Meet Mayo Clin. 1950 May 24;25(11):270–286. [PubMed] [Google Scholar]
  5. CARTER A. B. The immediate treatment of cerebral embolism. Q J Med. 1957 Jul;26(103):335–348. [PubMed] [Google Scholar]
  6. CASELLA L., ABELMANN W. H., ELLIS L. B. PATIENTS WITH MITRAL STENOSIS AND SYSTEMIC EMBOLI; HEMODYNAMIC AND CLINICAL OBSERVATIONS. Arch Intern Med. 1964 Dec;114:773–781. doi: 10.1001/archinte.1964.03860120085008. [DOI] [PubMed] [Google Scholar]
  7. COSGRIFF S. W. Chronic anticoagulant therapy in recurrent embolism of cardiac origin. Ann Intern Med. 1953 Feb;38(2):278–287. doi: 10.7326/0003-4819-38-2-278. [DOI] [PubMed] [Google Scholar]
  8. COSGRIFF S. W. Prophylaxis of recurrent embolism of intracardiac origin; protracted anticoagulant therapy on an ambulatory basis. J Am Med Assoc. 1950 Jul 8;143(10):870–872. doi: 10.1001/jama.1950.02910450010003. [DOI] [PubMed] [Google Scholar]
  9. Carter A. B. Prognosis of cerebral embolism. Lancet. 1965 Sep 11;2(7411):514–519. doi: 10.1016/s0140-6736(65)91473-x. [DOI] [PubMed] [Google Scholar]
  10. Coulshed N., Epstein E. J., McKendrick C. S., Galloway R. W., Walker E. Systemic embolism in mitral valve disease. Br Heart J. 1970 Jan;32(1):26–34. doi: 10.1136/hrt.32.1.26. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. DALEY R., MATTINGLY T. W., HOLT C. L., BLAND E. F., WHITE P. D. Systemic arterial embolism in rheumatic heart disease. Am Heart J. 1951 Oct;42(4):566–581. doi: 10.1016/0002-8703(51)90152-4. [DOI] [PubMed] [Google Scholar]
  12. Fleming H. A., Bailey S. M. Mitral valve disease, systemic embolism and anticoagulants. Postgrad Med J. 1971 Sep;47(551):599–604. doi: 10.1136/pgmj.47.551.599. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. GROCH S. N., McDEVITT E., WRIGHT I. S. A long-term study of cerebral vascular disease. Ann Intern Med. 1961 Sep;55:358–367. doi: 10.7326/0003-4819-55-3-358. [DOI] [PubMed] [Google Scholar]
  14. JORDAN R. A., SCHEIFLEY C. H., EDWARDS J. E. Mural thrombosis and arterial embolism in mitral stenosis; a clinico-pathologic study of fifty-one cases. Circulation. 1951 Mar;3(3):363–367. doi: 10.1161/01.cir.3.3.363. [DOI] [PubMed] [Google Scholar]
  15. KEEN G., LEVEAUX V. M. Prognosis of cerebral embolism in rheumatic heart disease. Br Med J. 1958 Jul 12;2(5088):91–92. doi: 10.1136/bmj.2.5088.91. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Marshall J. The prevention of strokes. Am Heart J. 1966 Jan;71(1):1–4. doi: 10.1016/0002-8703(66)90649-1. [DOI] [PubMed] [Google Scholar]
  17. OWREN P. A. The results of anticoagulant therapy in Norway. Arch Intern Med. 1963 Feb;111:240–247. doi: 10.1001/archinte.1963.03620260100018. [DOI] [PubMed] [Google Scholar]
  18. OWREN P. A. Thrombotest. A new method for controlling anticoagulant therapy. Lancet. 1959 Nov 7;2(7106):754–758. doi: 10.1016/s0140-6736(59)90857-8. [DOI] [PubMed] [Google Scholar]
  19. SOMERVILLE W., CHAMBERS R. J. SYSTEMIC EMBOLISM IN MITRAL STENOSIS: RELATION TO THE SIZE OF THE LEFT ATRIAL APPENDIX. Br Med J. 1964 Nov 7;2(5418):1167–1169. doi: 10.1136/bmj.2.5418.1167. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. SZEKELY P. SYSTEMIC EMBOLISM AND ANTICOAGULANT PROPHYLAXIS IN RHEUMATIC HEART DISEASE. Br Med J. 1964 May 9;1(5392):1209–1212. doi: 10.1136/bmj.1.5392.1209. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. TOWBIN A. Recurrent cerebral embolism; a cause of chronic organic brain disease. AMA Arch Neurol Psychiatry. 1955 Feb;73(2):173–192. [PubMed] [Google Scholar]
  22. WELLS C. E. Cerebral embolism; the natural history, prognostic signs and effects of anticoagulation. AMA Arch Neurol Psychiatry. 1959 Jun;81(6):667–677. [PubMed] [Google Scholar]
  23. WOOD J. C., CONN H. L., Jr Prevention of systemic arterial embolism in chronic rheumatic heart disease by means of protracted anticoagulant therapy. Circulation. 1954 Oct;10(4):517–523. doi: 10.1161/01.cir.10.4.517. [DOI] [PubMed] [Google Scholar]
  24. WOOD P. An appreciation of mitral stenosis. I. Clinical features. Br Med J. 1954 May 8;1(4870):1051–contd. doi: 10.1136/bmj.1.4870.1051. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES