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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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Risk of Stroke With Mitral Stenosis: The Underlying Mechanism, Treatment, and Prevention

Hamza Islam1, Sri Madhurima Puttagunta2, Rabia Islam1

  • 1Research, Faisalabad Medical University, Faisalabad, PAK.

Cureus
|May 6, 2022
PubMed

Insights

Mitral stenosis increases stroke risk, with mitral annular calcification being a key predictor. This review covers risk factors, assessment, and therapies including newer oral anticoagulants and non-pharmacological options for stroke prevention.

Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Background:

  • Mitral stenosis (MS) involves mitral valve narrowing, increasing stroke risk.
  • Common risk factors include mitral annular calcification (MAC), diabetes mellitus (DM), hypertension (HTN), and hyperlipidemia.
  • Thrombus formation is driven by endothelial damage, hypercoagulability, and left atrial blood stasis.

Purpose of the Study:

  • To review mechanisms of thromboembolism in MS.
  • To identify stroke risk factors and assessment models in MS patients.
  • To evaluate current and novel therapies for stroke prevention in MS.

Main Methods:

  • Comprehensive literature review on MS and stroke.
  • Analysis of risk factors, including MAC as an independent predictor.
  • Evaluation of newer oral anticoagulants (NOACs) and non-pharmacological therapies.

Main Results:

  • MAC is identified as an independent predictor of stroke in MS.
  • Review encompasses mechanisms, risk factors, and assessment strategies for stroke in MS.
  • Efficacy and safety of NOACs (dabigatran, edoxaban, apixaban, rivaroxaban) and interventions like LAA ligation/occlusion are discussed.

Conclusions:

  • Understanding MS-related stroke mechanisms is crucial for risk stratification.
  • NOACs and non-pharmacological approaches offer potential for stroke risk reduction.
  • Further research on optimal therapeutic strategies is warranted.

Keywords:
apixaban and edoxabancerebrovascular accident (stroke)cha2ds2-vascleft atrial thrombusmitral annular calcificationmitral valve stenosisnewer oral anticoagulantsthromboembolismvitamin k antagonists (vkas)watchman device

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