Related Experiment Videos
Thrombosis and the heart
1Department of Neurology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157-1078.
Insights
Cardiac disorders like atrial fibrillation are key causes of stroke due to thrombus formation. Advanced diagnostics and new therapies are improving the prevention of cardioembolic events.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- The heart is a primary site for thrombus formation, leading to cardioembolic stroke.
- Several cardiac conditions, including atrial fibrillation and valvular heart disease, elevate the risk of cardioembolism.
Purpose of the Study:
- To review cardiac factors contributing to cardioembolic stroke.
- To discuss current and emerging diagnostic and therapeutic strategies for preventing cardiac thrombus and embolism.
Main Methods:
- Review of literature on cardiac causes of stroke.
- Discussion of diagnostic tools such as transesophageal echocardiography (TEE) and intravascular ultrasound.
- Exploration of current and novel preventive therapies.
Main Results:
- Atrial fibrillation, left ventricular dysfunction, valvular heart disease, and structural abnormalities are major cardiac sources of emboli.
- Transesophageal echocardiography (TEE) enhances the identification of cardiac sources.
- Embolus detection monitoring and intravascular ultrasound offer potential for objective assessment and evaluation.
Conclusions:
- Understanding the heart-brain relationship is crucial for stroke prevention.
- New diagnostic methods and therapeutic approaches are vital for managing cardiac thrombus and reducing cardioembolic events.
- Further research into the heart-brain axis will significantly impact future clinical practice.
Abstract:
The heart is an important site for thrombus formation and cardioembolic events are a frequent cause of stroke. Many cardiac factors may contribute to the risk of cardioembolism. Clinicians must be mindful that those cardiac disorders most likely to cause cardioembolic events include atrial fibrillation, left ventricular dysfunction, valvular heart disease, and structural cardiac abnormalities. The presence of many such conditions mandates the use of specific preventive therapies. Improved diagnostic methods, particularly TEE, now allow more accurate identification and follow-up of potential cardiac sources. Embolus detection monitoring has the potential to allow in vivo identification of embolic events and offers the possibility of objective longitudinal assessment of the impact of therapy. Intravascular ultrasound is an invasive test, but it may eventually allow the most accurate evaluation of the cardiac chambers. New therapies, and new combinations of currently available compounds, may ultimately offer more specific and efficacious alternatives to prevent formation of cardiac thrombus and subsequent cardioembolism. The importance of the heart-brain relationship in stroke has finally been appreciated. Improved understanding of this complex interrelationship will have great impact on clinical practice in the future.