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Neurologic manifestations of cardiogenic embolism: an update
Santiago Palacio1, Robert G Hart
1Department of Medicine, Neurology, University of Texas Health Science Center, San Antonio, Texas 78229-3900, USA. palacioso@uthscsa.edu
Insights
Cardiogenic embolism, a preventable cause of stroke, is increasingly recognized. Transoesophageal echocardiography aids in identifying sources, guiding antithrombotic management for conditions like atrial fibrillation.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Cardiogenic embolism is a significant and preventable cause of ischemic stroke.
- Advances in transoesophageal echocardiography have improved the identification of cardiac sources of embolism.
- Understanding these sources is crucial for effective stroke prevention strategies.
Purpose of the Study:
- To review the role of cardiogenic embolism as an independent risk factor for stroke.
- To discuss the management implications of identified embolic sources based on current evidence.
- To characterize antithrombotic management strategies for patients with atrial fibrillation.
Main Methods:
- Literature review of recent evidence on cardiogenic embolism and stroke.
- Analysis of data from transoesophageal echocardiography studies.
- Synthesis of guidelines and clinical trial results for antithrombotic therapy.
Main Results:
- Transoesophageal echocardiography has revealed various cardiac sources of embolism, including atrial fibrillation and valvular heart disease.
- These sources are confirmed independent risk factors for stroke.
- Evidence supports tailored antithrombotic therapies based on stroke etiology and patient factors.
Conclusions:
- Cardiogenic embolism is a critical, modifiable cause of stroke.
- Accurate diagnosis of embolic sources is essential for appropriate treatment.
- Personalized antithrombotic management, particularly in atrial fibrillation, can significantly reduce stroke recurrence.
Abstract:
Cardiogenic embolism is increasingly appreciated as an important and preventable cause of stroke. Several potential sources of embolism have been identified with the advent of transoesophageal echocardiography. Their role as independent risk factors for stroke and management implications based on recent evidence, along with characterization of schemes for antithrombotic management of patients with atrial fibrillation are reviewed.