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Cardiogenic embolism causes one in six ischemic strokes. Identifying cardiac sources like atrial fibrillation is key, as many cardioembolic strokes are preventable through early diagnosis and treatment.
Area of Science:
- Cardiology
- Neurology
- Stroke Medicine
Background:
- Cardiogenic embolism accounts for a significant proportion of ischemic strokes.
- Nonrheumatic atrial fibrillation is the leading cause, increasing stroke risk fivefold.
- Other sources include ischemic heart disease, rheumatic mitral stenosis, and prosthetic valves.
Purpose of the Study:
- To review the natural history, diagnosis, prevention, and treatment of cardioembolic stroke.
- To highlight the importance of identifying cardiac sources for stroke prevention.
Main Methods:
- Literature review of current knowledge on cardioembolic stroke.
- Analysis of common and infrequent cardiac sources of embolism.
Main Results:
- Nonrheumatic atrial fibrillation is the most common cause of cardioembolic stroke.
- Ischemic heart disease, rheumatic mitral stenosis, and prosthetic valves are other major contributors.
- Mitral annulus calcification and calcific aortic stenosis are less frequent sources.
Conclusions:
- Many cardioembolic strokes are potentially preventable.
- Early identification of cardiac sources is crucial for effective stroke prevention strategies.
Abstract:
One in six ischemic strokes is due to cardiogenic embolism. The current knowledge about the natural history, diagnosis, prevention, and treatment of cardioembolic stroke is reviewed. Nonrheumatic atrial fibrillation is the most frequent substrate for brain embolism; patients with this dysrhythmia have a fivefold increase in the risk of stroke. Ischemic heart disease (25%), rheumatic mitral stenosis (10%), and prosthetic cardiac valves (10%) are other major sources of cardioembolic stroke. Mitral annulus calcification and calcific aortic stenosis infrequently serve as cardioembolic sources. As cardiac sources of embolic stroke are often identifiable prior to stroke, many of these strokes are potentially preventable.