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Updated: Jul 10, 2026
06:29
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
[Embolic stroke of cardiac origin]
Henrik Egeblad1, Bo Traberg Kristensen
1Arhus Universitetshospital, Skejby, Kardiologisk Afdeling B, Arhus N. egeblad@dadlnet.dk
Ugeskrift for Laeger
|October 24, 2007
Summary
Cardiac and aortic sources cause 20% of ischemic strokes. A selective diagnostic strategy, including echocardiography for specific patient groups, is recommended to identify these embolic stroke causes.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Embolism from cardiac sources (thrombi, vegetations, tumors) and proximal aorta thrombi account for 20% of ischemic stroke cases.
- Echocardiography can identify these embolic sources, but therapeutic implications are often limited.
Purpose of the Study:
- To recommend a selective diagnostic strategy for identifying embolic stroke origins.
- To define specific patient subgroups who would benefit most from further cardiac investigation.
Main Methods:
- Retrospective analysis of stroke cases attributed to cardiac or proximal aortic embolism.
- Review of diagnostic yield of echocardiography in identified patient cohorts.
- Development of a referral algorithm based on clinical presentation and risk factors.
Main Results:
- Identified key clinical indicators for embolic stroke, including atrial fibrillation, heart murmur, heart failure, and cryptogenic stroke in patients <=65 years.
- Highlighted the limited therapeutic impact of echocardiography without a targeted diagnostic approach.
Conclusions:
- A selective strategy for investigating potential embolic stroke sources is more effective than routine screening.
- Specific patient groups, including those with newly diagnosed atrial fibrillation, heart murmur, heart failure, or unexplained stroke under 65, warrant urgent cardiac evaluation.
- Transesophageal echocardiography may be necessary for further clarification in select cases.
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