The role of LAE in acute cerebral infarction patient is not sufficiently described in literature. Hence this study was undertaken to look for the frequency of left atrial enlargement in acute stroke subtypes.

LAE related rhythm disturbance that characterize atrial fibrillation is also associated with other atrial derangement such as endothelial dysfunction and impaired myocyte function.

119 patients with acute ischemic stroke admitted during the study period (June 2016 to March 18) were included. Using clinical data, radiological images and investigation results, stroke subtype of each patient was determined based TOAST criteria. P wave morphology in lead V1 of ECG was evaluated in each patient to look for left atrial enlargement and PTFV1 > 4,000 microvolt ms was considered to be left atrial enlargement by ECG voltage criteria.

Out of 154 patients, 64 (41.5%) had LAE. Small artery occlusion was found among 20.1% patients and large artery atherosclerosis was seen among 17.5% patients. Hypertension was most common risk factor (61.6%), followed by LAE (41.5%) and Diabetes mellitus (38.3%). Indexed LA diameter was significantly (p=0.001) higher in Cardio embolic group (2.67±0.30) than other groups. LAE was most frequent in the cardio embolic group (40.6%) followed by undetermined cause group (35.9%).

Second Highest frequency of LAE found in undermined group raises the possibility cardiogenic origin of stroke, at least in some of these patients. As these patient would be prone to recurrent stroke, patients with LAE should be evaluated in detail including more prolonged holter. Further given the proven benefit of anticoagulant therapy in preventing left atrial thromboembolism in patients with AF, further studies may be worthwhile to determine optimal markers of atrial cardiopathy and the effect of anticoagulant therapy in patients with conclusive evidence of atrial cardiopathy, but no clear evidence of AF.