Osman O. Al-Radi, MBBS, Division of Cardiac Surgery, University of Toronto, Toronto, ON.

Mitral regurgitation is a frequent complication of coronary artery disease (CAD), and it also frequently co-exists with CAD. The surgical management of mitral regurgitation is dependent on its clinical presentation as well as the pathophysiology of regurgitation. A brief discussion of the pathophysiology of mitral regurgitation and a modified version of the Carpentier classification are presented.
Key words: mitral regurgitation, echocardiography, Carpentier classification.

Alejandro Floh, BSc

Echocardiography has long been recognized as one of the most valuable non-invasive methods of investigating the heart. With recently-acquired understanding of the importance of cardiac disease in the pathogenesis of stroke, the role of echocardiography, whether transthoracic or transesophageal, in the management of stroke patients has become an area of extensive study. The Canadian Task Force on Preventive Health Care has therefore released their recommendations for the use of this imaging technique in newly diagnosed stroke patients.

Cerebral ischemia, a form of cerebral vascular disease, is caused by the reduction of blood supply to the nervous tissue of the brain. The result is often a rapid onset of focal neurological deficit or global impairment; this is commonly referred to as a stroke or cerebral vascular accident (CVA).¹ Despite similar presentations, the etiology of ischemic strokes vary considerably, and must be differentiated rapidly in order to provide appropriate care.

Despite new diagnostic and treatment modalities, stroke continues to be the third largest cause of mortality in Canada and the leading cause of disability.^2,3 Currently, approximately 50,000 new cases of strokes emerge annually, leading to an overall prevalence of 200,000 cases.³ Furthermore, strokes continue to be a leading cause of hospital admissions, even higher than acute myocardial infarctions, costing the Canadian health care system $2.