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The role of echocardiography in the embolic stroke of undetermined source
Alessandra Danese1, Giacomo Mugnai2, Francesca Prevedello2
1Division of Neurology.
Insights
Echocardiography is vital for diagnosing and preventing recurrent embolic strokes of undetermined source. Prompt echocardiography helps identify cardiac causes like atrial fibrillation, preventing further ischemic events.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Embolic stroke of undetermined source (ESUS) poses a significant risk for recurrent ischemic events, particularly within the first week.
- Early identification of stroke etiology is crucial for effective management and prevention strategies.
Purpose of the Study:
- To review the importance and practical application of echocardiography in diagnosing the embolic source in acute stroke patients.
- To highlight echocardiography's role in preventing recurrent ischemic strokes.
Main Methods:
- Review of current literature and clinical guidelines on echocardiography in stroke diagnosis.
- Discussion of echocardiography's utility in detecting cardiac sources of embolism.
Main Results:
- Echocardiography is essential for identifying potential embolic sources such as atrial fibrillation, ventricular dysfunction, aortic plaques, and cardiac shunts.
- Timely echocardiography aids in preventing secondary ischemic stroke by identifying treatable cardiac conditions.
Conclusions:
- Echocardiography is a critical, prompt diagnostic tool in the acute stroke setting for identifying embolic sources.
- Early echocardiographic evaluation is recommended for patients with stroke of undetermined source to guide treatment and prevent recurrence.
Abstract:
: Echocardiography plays an important role both in the diagnosis and the treatment/prevention of embolic stroke of undetermined source and should be performed as soon as possible for preventing ischemic stroke recurrencies, which occur more frequently during the first week after the first ischemic event. Early identification of the cause of a transient ischemic attack or stroke is indeed a primary goal for the neurologist in the Stroke Unit and requires specific diagnostic strategies. Echocardiography, together with other diagnostic tools such as carotid and transcranial ultrasounds, provides this information promptly. In particular, echocardiography might be able to detect the main sources of the embolic stroke, such as atrial fibrillation, ventricular akinesia, aortic atheroma plaques and/or cardiac shunts. The present review discusses the importance and the practical role of echocardiography as a crucial diagnostic tool for detecting the main source of emboli in the setting of the acute stroke.
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