Objective: Detection of paroxysmal atrial fibrillation (PAF) in patients with acute stroke is often difficult. Dilatation of left atrium dimension (LAD) and increased levels of brain natriuretic peptide (BNP) are reported to indicate cerebral embolism due to PAF. We assessed the usefulness of chest X-ray in predicting LAD and BNP among patients with acute cerebral infarction. Methods: We included 141 consecutive patients with cerebral infarction [107 cerebral thromboses (cerebral thrombosis group)] and 34 cardiogenic cerebral embolisms due to PAF (PAF group). Transthoracic echocardiography (TTE) was used to evaluate LAD (TTE-LA). On chest X-ray, heart diameter at the third aortic arch (XP-LA) and XP-LA divided by maximum intrathoracic diameter (XP-LA ratio) were measured. Results: TTE-LA, XP-LA, XP-LA ratio and BNP levels were significantly higher in PAF group compared with those in cerebral thrombosis group. XP-LA had a significant positive correlation with TTE-LA (r = 0.332, p
< 0.0001) and BNP (r = 0.292, p
< 0.001). XP-LA ratio also showed a significant correlation with TTE-LA (r = 0.210, p = 0.0126) and BNP (r = 0.515, p
< 0.0001). Conclusion: We suggest chest X-ray is a simple and useful tool for predicting LAD and BNP.
For a period of 4 years, we conducted deep vein thrombosis (DVT) examinations among people living in temporary homes and those living in their own homes in areas affected by the Great East Japan Earthquake. We divided those with positive results for DVT after receiving numerous examinations into a DVT disappeared group and a DVT remained group. The thrombus formation sites were the soleus muscle veins for both groups. In terms of characteristics, multiple organized thrombi were recognized, and there was no spread to the central side. In addition, the DVT remained group exhibited an increased maximum diameter of the soleal vein. We believe that stasis of blood flow due to the extension of the soleal veins contributed to the continued formation of thrombi.