open access

Vol 13, No 1 (2018)
Review Papers
Published online: 2018-03-22
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Stroke as a result of cardioembolism — characteristic features in the context of diagnostic methods and secondary prevention

Paulina Ewelina Gąsiorek, Maciej Banach, Marek Maciejewski, Andrzej Głąbiński, Aleksandra Paduszyńska, Agata Bielecka-Dąbrowa
DOI: 10.5603/FC.2018.0004
·
Folia Cardiologica 2018;13(1):21-28.

open access

Vol 13, No 1 (2018)
Review Papers
Published online: 2018-03-22

Abstract

Embolism of cardiac origin accounts for around 15–30% of ischaemic strokes. It is worth noting that stroke from a cardiac source carries a poorer outcome compared with other sources, having a 50% mortality at three years. Diagnosis of the cardioembolic source of stroke is frequently uncertain and relies on the identification of the potential cardiac source of embolism in the absence of significant autochthone cerebrovascular occlusive disease. Early diagnosis and appropriate treatment are mandatory to prevent the recurrent events that can lead to greater disability and the increased healthcare cost. Since cardioembolic stroke is not a single disease entity, its diagnosis requires initial clinical suspicion and a comprehensive evaluation, including electrocardiography, echocardiography, brain imaging, and cardiac monitoring. There are characteristic features suggestive of cardioembolic stroke, which help the clinicians to choose a right direction of diagnosis. The primary role of echocardiography is to establish the existence of the source of embolism, determine the likelihood that such a source is a plausible cause of stroke or systemic embolism, and guide the therapy in an individual patient. There is still a need for further studies assessing the optimal diagnostic methods of potential cardiac sources of embolism and establishment of the rules of the optimal medical prevention (antiplatelet therapy versus oral anticoagulation) and interventional procedures to reduce the incidence of ischaemic strokes.

Abstract

Embolism of cardiac origin accounts for around 15–30% of ischaemic strokes. It is worth noting that stroke from a cardiac source carries a poorer outcome compared with other sources, having a 50% mortality at three years. Diagnosis of the cardioembolic source of stroke is frequently uncertain and relies on the identification of the potential cardiac source of embolism in the absence of significant autochthone cerebrovascular occlusive disease. Early diagnosis and appropriate treatment are mandatory to prevent the recurrent events that can lead to greater disability and the increased healthcare cost. Since cardioembolic stroke is not a single disease entity, its diagnosis requires initial clinical suspicion and a comprehensive evaluation, including electrocardiography, echocardiography, brain imaging, and cardiac monitoring. There are characteristic features suggestive of cardioembolic stroke, which help the clinicians to choose a right direction of diagnosis. The primary role of echocardiography is to establish the existence of the source of embolism, determine the likelihood that such a source is a plausible cause of stroke or systemic embolism, and guide the therapy in an individual patient. There is still a need for further studies assessing the optimal diagnostic methods of potential cardiac sources of embolism and establishment of the rules of the optimal medical prevention (antiplatelet therapy versus oral anticoagulation) and interventional procedures to reduce the incidence of ischaemic strokes.
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Keywords

ischaemic stroke, echocardiography, embolism, brain imaging

About this article
Title

Stroke as a result of cardioembolism — characteristic features in the context of diagnostic methods and secondary prevention

Journal

Folia Cardiologica

Issue

Vol 13, No 1 (2018)

Pages

21-28

Published online

2018-03-22

DOI

10.5603/FC.2018.0004

Bibliographic record

Folia Cardiologica 2018;13(1):21-28.

Keywords

ischaemic stroke
echocardiography
embolism
brain imaging

Authors

Paulina Ewelina Gąsiorek
Maciej Banach
Marek Maciejewski
Andrzej Głąbiński
Aleksandra Paduszyńska
Agata Bielecka-Dąbrowa

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