When an Undiagnosed Heart Condition Leads to a Stroke
Posted on in Medical Negligence
Most people think of a stroke as a condition affecting the brain. However, in many cases, the underlying cause begins in the heart.
Some heart conditions can allow blood clots to form inside the heart. If a clot breaks away, it can travel through the bloodstream to the brain, blocking an artery and causing an ischaemic stroke. These strokes can often be prevented if the underlying heart condition is recognised and treated in time.
Which heart conditions increase the risk of stroke?
Several cardiac conditions are known to increase the risk of stroke, including:
- Atrial Fibrillation (AF)
AF is the most common heart rhythm disorder. Instead of beating in a regular rhythm, the heart's upper chambers quiver, allowing blood to pool and increasing the likelihood of clot formation.
People with AF are around five times more likely to suffer a stroke than those without it. The good news is that many patients can significantly reduce this risk by taking anticoagulant ("blood-thinning") medication once the condition has been diagnosed.
- Heart Valve Disease
Conditions affecting the heart valves, including severe aortic stenosis or mitral valve disease, can alter blood flow through the heart.
Whilst severe aortic stenosis is more commonly associated with symptoms such as breathlessness, chest pain and fainting, advanced valve disease can also contribute to an increased risk of stroke in some patients, particularly where it leads to atrial fibrillation or other complications.
- Cardiomyopathy
Diseases that weaken or enlarge the heart muscle may reduce the heart's ability to pump blood effectively, increasing the risk of clot formation.
- Infective Endocarditis
This is a serious infection affecting the heart valves. Small, infected fragments can break away and travel to the brain, causing a stroke.
When can things go wrong?
Many people experience warning signs long before a stroke occurs. These may include:
- Episodes of a racing or irregular heartbeat.
- Palpitations.
- Unexplained dizziness or fainting.
- Breathlessness.
- Chest discomfort.
- Reduced exercise tolerance.
These symptoms do not always mean someone has a serious heart condition, but they should be properly assessed. Depending on the circumstances, investigations may include an ECG, longer-term heart rhythm monitoring, blood tests or an echocardiogram (an ultrasound scan of the heart).
Where these symptoms are overlooked or not investigated appropriately, an opportunity to diagnose and treat the underlying condition may be missed.
Example case study
John, a 72-year-old retired teacher, visited his GP on three occasions over an eight-month period complaining of intermittent palpitations, tiredness and occasional dizziness. During one appointment, his pulse was noted to be irregular, but this was attributed to anxiety and no ECG or further investigations were arranged.
Several months later, John suddenly developed weakness down his right side and difficulty speaking. He was taken to hospital where doctors confirmed he had suffered an ischaemic stroke.
During his admission, an ECG demonstrated atrial fibrillation. Further assessment concluded that the stroke had almost certainly been caused by a blood clot that had formed in his heart before travelling to his brain.
John required several months of rehabilitation. Although he regained some mobility, he was left with ongoing weakness in his right arm and struggled with speech and fatigue. He was unable to return to many of the activities he had previously enjoyed.
Had atrial fibrillation been identified when John first reported his symptoms, anticoagulant medication would probably have been prescribed. On the balance of probabilities, this would have significantly reduced the risk of the stroke occurring.
Could this amount to medical negligence?
Not every stroke caused by an undiagnosed heart condition results from negligent medical care. Heart conditions can sometimes be difficult to detect, particularly if symptoms are intermittent.
However, concerns may arise where healthcare professionals fail to:
- Take an appropriate history.
- Recognise symptoms suggesting an underlying heart condition.
- Arrange reasonable investigations.
- Refer a patient to an appropriate specialist where indicated.
- Prescribe preventative treatment once a diagnosis has been made.
To establish a medical negligence claim, you must show both that the standard of care fell below what would reasonably be expected and that earlier diagnosis or treatment would probably have prevented, or significantly reduced, the severity of the stroke.
Early diagnosis saves lives
Many strokes associated with heart disease are preventable. Recognising symptoms, carrying out appropriate investigations and starting timely treatment can dramatically reduce the risk of life-changing injury.
Contact us
For individuals and families affected by stroke, understanding whether opportunities were missed can be an important part of obtaining answers. A careful review of the medical records by independent experts can often establish whether earlier diagnosis and treatment may have altered the outcome.
If you or a family member has been affected by medical negligence, contact our specialist medical negligence lawyers; we will help you to recover appropriate compensation and secure your future.