Cardioembolic Stroke

Cumara B. O'Carroll, Kevin M Barrett

Research output: Contribution to journalReview article

19 Scopus citations

Abstract

Purpose of Review: Cardioembolic stroke is common and disproportionately more disabling than nonembolic mechanisms of stroke. Its incidence is expected to rise because of the age-related incidence of atrial fibrillation and an aging population. This article summarizes the different causes of cardioembolism and outlines current management guidelines. Recent Findings: Since cardioembolic stroke is not a single disease entity, its diagnosis requires initial clinical suspicion and a comprehensive evaluation, including ECG, echocardiography, brain imaging, and cardiac monitoring. Atrial fibrillation is the most common cause of cardioembolic stroke, and anticoagulation is usually recommended. This article reviews risk stratification models to assist in the decision-making process and highlights the increased use of novel oral anticoagulants for stroke prevention in atrial fibrillation. New data support the importance of prolonged cardiac monitoring for diagnosing occult atrial fibrillation. Current data on other mechanisms of cardioembolic stroke, such as prosthetic heart valves and aortic arch atherosclerosis, are also presented, and the available evidence regarding patent foramen ovale closure in cryptogenic stroke is summarized. Summary: Cardioembolism is an important cause of ischemic stroke, with diverse underlying mechanisms requiring a tailored approach to diagnosis, management, and prevention.

Original languageEnglish (US)
Pages (from-to)111-132
Number of pages22
JournalCONTINUUM Lifelong Learning in Neurology
Volume23
Issue number1
DOIs
StatePublished - Feb 1 2017

ASJC Scopus subject areas

  • Clinical Neurology
  • Genetics(clinical)

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