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Embolic Middle Cerebral Artery Occlusion (MCAO) for Ischemic Stroke with Homologous Blood Clots in Rats
09:11

Embolic Middle Cerebral Artery Occlusion (MCAO) for Ischemic Stroke with Homologous Blood Clots in Rats

Published on: September 17, 2014

Management of cerebral embolism of cardiac origin

J D Easton, D G Sherman

    Stroke
    |September 1, 1980
    PubMed

    Insights

    Cerebral embolism risk from rheumatic heart disease, myocardial infarction, and atrial fibrillation is significant. Anticoagulation therapy effectively reduces embolism incidence and recurrence in these cardiac conditions.

    Area of Science:

    • Cardiology
    • Neurology
    • Vascular Medicine

    Background:

    • Cerebral embolism is a serious complication of several cardiac conditions.
    • Rheumatic heart disease (RHD), atherosclerotic heart disease (myocardial infarction, atrial arrhythmias), and nonvalvular atrial fibrillation (AF) are primary cardiac sources.
    • Understanding the natural history of embolism from these sources is crucial for prevention.

    Purpose of the Study:

    • To review the natural history of cerebral embolism originating from common cardiac conditions.
    • To evaluate the efficacy of anticoagulation in reducing embolism and recurrence.
    • To provide recommendations for anticoagulation use and timing.

    Main Methods:

    • Literature review of studies on cardiac conditions and cerebral embolism.
    • Analysis of data on embolism incidence, recurrence, and the impact of anticoagulation.
    • Review of data on valvulotomy and prosthetic valve placement in RHD.

    Main Results:

    • Rheumatic heart disease with mitral stenosis is a significant source of emboli, with 10-20% experiencing systemic embolism and high recurrence rates.
    • Myocardial infarction leads to systemic emboli in 5-12% of patients, with significant recurrence.
    • As many as 10-20% of patients with nonrheumatic AF experience systemic emboli.
    • Anticoagulation reduces embolism in RHD to 10-20% of natural incidence and recurrence rates.
    • Anticoagulation reduces embolism in myocardial infarction to 25% of natural incidence.
    • The effect of anticoagulation on nonrheumatic AF embolism is unknown.

    Conclusions:

    • Anticoagulation is highly effective in mitigating the risk of cerebral embolism and recurrence in RHD and myocardial infarction.
    • Further research is needed to determine the role of anticoagulation in nonrheumatic AF.
    • Recommendations for anticoagulation strategies are based on current evidence for these cardiac conditions.

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