Abstract
Cardioembolism represents a common source of ischemic stroke. The pathophysiology of emboli can differ significantly, with differing treatments. These can include embolism from atrial fibrillation, congestive heart failure, infective endocarditis, inflammatory endocarditis, aortic valve atheroma, aortic dissection, deep venous thrombosis in the presence of right-to-left shunt, atrial septal defect, and mechanical circulatory support devices. Here we will discuss when to suspect cardioembolism, diagnostic approach, and optimal treatment strategies.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Mohr JP, Wolf PA, Grotta JC, Moskowitz MA, Mayberg MR, von Kummer R (2011) Stroke: pathophysiology, diagnosis, and management, vol 5. Elsevier, Inc., Amsterdam
Bozzao L, Fantozzi LM, Bastianello S et al (1989) Ischaemic supratentorial stroke: angiographic findings in patients examined in the very early phase. J Neurol 236(6):340–342
National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group (1995) Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 333(24):1581–1587
Lip GY, Gibbs CR (1999) Does heart failure confer a hypercoagulable state? Virchow’s triad revisited. J Am Coll Cardiol 33(5):1424–1426
Zile MR, Gaasch WH, Anand IS et al (2010) Mode of death in patients with heart failure and a preserved ejection fraction: results from the Irbesartan in heart failure with preserved ejection fraction study (I-Preserve) trial. Circulation 121(12):1393–1405
Mohr JP, Caplan LR, Melski JW et al (1978) The Harvard cooperative stroke registry: a prospective registry. Neurology 28(8):754–762
Bogousslavsky J, Van Melle G, Regli F (1988) The Lausanne stroke registry: analysis of 1,000 consecutive patients with first stroke. Stroke 19(9):1083–1092
Bogousslavsky J, Cachin C, Regli F, Despland PA, Van Melle G, Kappenberger L (1991) Cardiac sources of embolism and cerebral infarction—clinical consequences and vascular concomitants: the Lausanne stroke registry. Neurology 41(6):855–859
Cacciatore A, Russo LS Jr (1991) Lacunar infarction as an embolic complication of cardiac and arch angiography. Stroke 22(12):1603–1605
Hart RG, Foster JW, Luther MF, Kanter MC (1990) Stroke in infective endocarditis. Stroke 21(5):695–700
Futrell N (2004) Lacunar infarction: embolism is the key. Stroke 35(7):1778–1779
Sanna T, Diener HC, Passman RS et al (2014) Cryptogenic stroke and underlying atrial fibrillation. N Engl J Med 370(26):2478–2486
Pearson AC, Nagelhout D, Castello R, Gomez CR, Labovitz AJ (1991) Atrial septal aneurysm and stroke: a transesophageal echocardiographic study. J Am Coll Cardiol 18(5):1223–1229
Mattioli AV, Aquilina M, Oldani A, Longhini C, Mattioli G (2001) Atrial septal aneurysm as a cardioembolic source in adult patients with stroke and normal carotid arteries. A multicentre study. Eur Heart J 22(3):261–268
Gaul C, Dietrich W, Friedrich I, Sirch J, Erbguth FJ (2007) Neurological symptoms in type A aortic dissections. Stroke 38(2):292–297
Adams HP Jr, Bendixen BH, Kappelle LJ et al (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of org 10172 in acute stroke treatment. Stroke 24(1):35–41
Goldstein LB, Jones MR, Matchar DB et al (2001) Improving the reliability of stroke subgroup classification using the trial of ORG 10172 in acute stroke treatment (TOAST) criteria. Stroke 32(5):1091–1098
Radu RA, Terecoasa EO, Bajenaru OA, Tiu C (2017) Etiologic classification of ischemic stroke: where do we stand? Clin Neurol Neurosurg 159:93–106
Fagan SM, Chan KL (2000) Transesophageal echocardiography risk factors for stroke in nonvalvular atrial fibrillation. Echocardiography 17(4):365–372
Llombart V, Antolin-Fontes A, Bustamante A et al (2015) B-type natriuretic peptides help in cardioembolic stroke diagnosis: pooled data meta-analysis. Stroke 46(5):1187–1195
He J, Tse G, Korantzopoulos P et al (2017) P-wave indices and risk of ischemic stroke: a systematic review and meta-analysis. Stroke 48(8):2066–2072
Brambatti M, Connolly SJ, Gold MR et al (2014) Temporal relationship between subclinical atrial fibrillation and embolic events. Circulation 129(21):2094–2099
Powers WJ, Derdeyn CP, Biller J et al (2015) 2015 American Heart Association/American Stroke Association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 46(10):3020–3035
Stroke Prevention in Atrial Fibrillation Study (1991) Final results. Circulation 84(2):527–539
Berge E, Abdelnoor M, Nakstad PH, Sandset PM (2000) Low molecular-weight heparin versus aspirin in patients with acute ischaemic stroke and atrial fibrillation: a double-blind randomised study. HAEST study group. Heparin in acute embolic stroke trial. Lancet 355(9211):1205–1210
Maron BJ, Olivotto I, Bellone P et al (2002) Clinical profile of stroke in 900 patients with hypertrophic cardiomyopathy. J Am Coll Cardiol 39(2):301–307
Homma S, Thompson JL, Pullicino PM et al (2012) Warfarin and aspirin in patients with heart failure and sinus rhythm. N Engl J Med 366(20):1859–1869
Carroll JD, Saver JL, Thaler DE et al (2013) Closure of patent foramen ovale versus medical therapy after cryptogenic stroke. N Engl J Med 368(12):1092–1100
Kent DM, Ruthazer R, Weimar C et al (2013) An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke. Neurology 81(7):619–625
Amarenco P, Davis S, Jones EF et al (2014) Clopidogrel plus aspirin versus warfarin in patients with stroke and aortic arch plaques. Stroke 45(5):1248–1257
Shah P, Tantry US, Bliden KP, Gurbel PA (2017) Bleeding and thrombosis associated with ventricular assist device therapy. J Heart Lung Transplant 36(11):1164–1173
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Science+Business Media, LLC, part of Springer Nature
About this protocol
Cite this protocol
Padrick, M.M., Lahiri, S., Schlick, K. (2021). Embolic Ischemic Stroke. In: Al-Mufti, MD, F., Amuluru MD, K. (eds) Cerebrovascular Disorders. Neuromethods, vol 170. Humana, New York, NY. https://doi.org/10.1007/978-1-0716-1530-0_17
Download citation
DOI: https://doi.org/10.1007/978-1-0716-1530-0_17
Published:
Publisher Name: Humana, New York, NY
Print ISBN: 978-1-0716-1529-4
Online ISBN: 978-1-0716-1530-0
eBook Packages: Springer Protocols