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Published on: January 15, 2017
The Heart Brain Team and Patient-Centered Management of Ischemic Stroke
Mohamad Alkhouli1, Issam Moussa2, Abhishek Deshmukh1
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Insights
Cardiologists and neurologists can improve ischemic stroke care through a collaborative heart-brain team approach. This strategy addresses conditions like atrial fibrillation and carotid disease, enhancing patient outcomes.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Stroke Research
Background:
- The heart and brain exhibit complex interconnections studied across anatomical, pathophysiological, and clinical domains.
- Cardiologists and neurologists play crucial roles in managing cardiovascular and neurological disorders.
- A unified heart-brain team approach is often limited to specialized centers.
Purpose of the Study:
- To review the intersection of cardiology and neurology concerning ischemic stroke.
- To explore challenges and opportunities for a heart-team approach in stroke management.
- To focus on specific conditions including atrial fibrillation, carotid disease, and patent foramen ovale.
Main Methods:
- Literature review of studies on heart-brain interactions in ischemic stroke.
- Analysis of clinical scenarios involving atrial fibrillation, carotid disease, and patent foramen ovale.
- Examination of stroke cases complicating transcatheter endovascular interventions.
Main Results:
- Identified key areas where cardiology and neurology intersect in ischemic stroke etiology and management.
- Highlighted the potential benefits of a multidisciplinary heart-team approach for stroke patients.
- Discussed specific challenges in implementing team-based care for complex stroke cases.
Conclusions:
- A collaborative heart-brain team approach is essential for optimizing ischemic stroke care.
- Integrating cardiologists and neurologists can improve management of stroke related to atrial fibrillation, carotid disease, and PFO.
- Further development of team-based strategies is needed, especially for strokes during endovascular procedures.
Abstract:
The multifaceted connections between the heart and the brain have been extensively studied at the anatomy, pathophysiology, and clinical levels. Studies have suggested a vital role for both cardiologists and neurologists in the management of various cardiovascular and neurological disorders. However, a true heart-brain team-based approach remained confined to large, specialized centers. In this paper, we review the various intersection areas of cardiology and neurology with regard to ischemic stroke. We focus our discussion on the challenges and opportunity for a heart-team approach to stroke in the context of atrial fibrillation, carotid disease, and patent foramen ovale, and in the setting of strokes complicating transcatheter endovascular interventions.
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