Cardiac sources of embolism may promote ischemic colitis.
In this study, physicians from France evaluated their role in segmental, nongangrenous ischemic colitis. They also determined the usefulness of routine cardiac evaluation in patients with this disease.
The team matched 60 patients with 60 controls.
They assessed subjects' treatment and prior cardiovascular history or risk factors.
The physicians found that case and control patients had similar drug use, prior cardiovascular history, and risk factors.
They classified potential cardiac sources of embolism as "proven" or "still debated".
Patients were screened using an electrocardiogram, rhythmic Holter monitoring over 24 hours, and transthoracic echocardiography.
The team identified a potential cardiac source of embolism in 43% of cases, compared with 23% of controls.
|A potential cardiac source of embolism was identified in 43% of cases.|
|American Journal of Gastroenterology|
They established that 35% of cases and 13% of controls had a “proven” cardiac source of embolism.
However, they found that electrocardiogram alone misdiagnosed 72% of the “proven” cardiac sources of embolism.
A combination electrocardiogram plus Holter monitoring detected 71%, and electrocardiogram plus echocardiography 62%.
The researchers identified 12 of 21 case patients with at least 1 proven cardiac source of embolism that were previously unknown.
Anticoagulant therapy was required in 32% of case patients and antiarrhythmic therapy in 25% of cases.
Dr Isabelle Hourmand-Ollivier's team concluded, "Potential cardiac sources of embolism were more common in patients with segmental, nongangrenous ischemic colitis than in control patients".
"Therefore, these patients should undergo a routine electrocardiogram, rhythmic Holter monitoring, and transthoracic echocardiography".
"Anticoagulant therapy should also be considered for this patient population".