Evaluation and prevention of cardioembolic stroke

The potential for cardioembolic stroke has important implications for clinical management. This review describes the diagnostic workup and management options for this key stroke subtype.

The suspicion for a cardioembolic source for stroke is raised with a large vessel occlusion or when strokes occur in multiple vascular territories. Diagnostic workup includes ECG, echocardiography, and cardiac monitoring. Atrial fibrillation is the most common cause of cardioembolic stroke and typically justifies anticoagulation therapy. New data on other mechanisms of cardioembolic stroke--such as congestive heart failure, prosthetic valves, and aortic arch disease--as well as the availability of novel oral anticoagulants have implications for optimizing stroke prevention.

Cardiogenic embolization is an important cause of stroke with important implications for diagnosis, treatment, and prevention.