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Cardioembolic stroke: practical considerations for patient risk management and secondary prevention

Hardik Amin1, Richard J Nowak, Joseph L Schindler

  • 1Department of Neurology, Yale University School of Medicine, New Haven, CT.

Postgraduate Medicine
|January 8, 2014
PubMed

Insights

Cardioembolic stroke, often caused by atrial fibrillation, has high morbidity. This review covers diagnosis, management, and prevention strategies for cardioembolic stroke, including new anticoagulation therapies and managing reduced ejection fraction.

Area of Science:

  • Neurology
  • Cardiology
  • Internal Medicine

Background:

  • Cardioembolic (CE) stroke accounts for about 20% of ischemic strokes.
  • Atrial fibrillation is the most frequent cause of CE stroke.
  • CE strokes are linked to significant morbidity and early recurrence.

Purpose of the Study:

  • To review the diagnosis and management of CE stroke from various cardiac origins.
  • To highlight advances in primary and secondary prevention of CE stroke.
  • To discuss emerging data on atrial fibrillation monitoring and new anticoagulation.

Main Methods:

  • Literature review focusing on diagnosis and management of CE stroke.
  • Synthesis of current understanding of cardiac mechanisms leading to CE stroke.
  • Analysis of recent advancements in risk management and preventative therapies.

Main Results:

  • Established atrial fibrillation as a primary CE stroke mechanism.
  • Growing understanding of other cardiac sources: valvular disease, LV dysfunction, PFO.
  • Identified key areas for improved primary and secondary prevention strategies.

Conclusions:

  • Comprehensive management of CE stroke requires addressing diverse cardiac etiologies.
  • Advances in anticoagulation and monitoring offer improved secondary prevention for atrial fibrillation patients.
  • Further research into managing reduced ejection fraction is crucial for preventing CE stroke.

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