Cardioembolic stroke

Abstract

The paper considers the main causes and pathogenetic, clinical, and therapeutic aspects of cardioembolic stroke (CES). The latter is emphasized to be a group of conditions, which is highly heterogeneous in its etiology, pathogenesis, course, and prognosis. Their major risk factors are atrial fibrillation (AF), myocardial infarction (MI), and heart valve apparatus pathology. The leading diagnostic method for CES is brain computed tomography or magnetic resonance imaging, which most commonly visualize a well-defined wedge-shaped area of ischemia on the gray and white matter boundary, as well as cardiological examination. The results of electrocardiography, among them the detection of AF or MI, and echocardiography are of key value for correct diagnosis. Patients with CES are managed by the common principles applied to ischemic stroke. Oral anticoagulants, the efficacy and safety of which have been proven in large clinical trials, are most widely used to prevent recurrent CES. The patients who are at risk for CEA must be followed up by both a cardiologist and a neurologist. Adequate and individualized therapy can substantially reduce the likelihood of cerebrovascular disorders in this category of patients.

Keywords

• cardioembolic stroke
• diagnosis
• prevention
• novel oral anticoagulants