[Cardiac diagnostics after ischemic stroke or transitory ischemic attack]

Area of Science:

• Neurology
• Cardiology
• Public Health

Background:

• Stroke is a leading cause of death and disability worldwide.
• Cardio-embolic strokes, often caused by atrial fibrillation, have a worse prognosis and higher recurrence risk.
• Timely identification of atrial fibrillation is essential for effective secondary stroke prevention.

Purpose of the Study:

• To outline the diagnostic approach for identifying cardio-embolic sources in ischemic stroke patients.
• To emphasize the importance of early atrial fibrillation detection for stroke management.
• To guide the selection of appropriate diagnostic tests for secondary stroke prevention.

Main Methods:

• Structured medical history and physical examination.
• 12-lead ECG and 72-hour Holter monitoring.
• Transthoracic and transesophageal echocardiography for suspected atrial embolic sources.
• Consideration of advanced imaging (MRI/CT) and prolonged monitoring in select cases.

Main Results:

• A systematic evaluation protocol aids in identifying stroke etiology.
• Atrial fibrillation is a primary target in cardio-embolic stroke work-up.
• Diagnostic yield varies, necessitating tailored investigations based on clinical suspicion.

Conclusions:

• Early and accurate diagnosis of atrial fibrillation is paramount for secondary stroke prevention.
• A structured, multi-modal diagnostic approach optimizes the identification of cardio-embolic sources.
• Personalized extended cardiac work-up improves stroke management strategies.