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Evaluation and Prevention of Cardioembolic Stroke

Kim, Anthony S. MD, MAS

doi: 10.1212/01.CON.0000446103.82420.2d
Review Articles

Purpose of Review:: The potential for cardioembolic stroke has important implications for clinical management. This review describes the diagnostic workup and management options for this key stroke subtype.

Recent Findings:: The suspicion for a cardioembolic source for stroke is raised with a large vessel occlusion or when strokes occur in multiple vascular territories. Diagnostic workup includes ECG, echocardiography, and cardiac monitoring. Atrial fibrillation is the most common cause of cardioembolic stroke and typically justifies anticoagulation therapy. New data on other mechanisms of cardioembolic stroke—such as congestive heart failure, prosthetic valves, and aortic arch disease—as well as the availability of novel oral anticoagulants have implications for optimizing stroke prevention.

Summary:: Cardiogenic embolization is an important cause of stroke with important implications for diagnosis, treatment, and prevention.

Address correspondence to Dr Anthony S. Kim, UCSF Department of Neurology, Sandler Neurosciences Center, 675 Nelson Rising Lane, Room 411B, San Francisco, CA 94158, akim@ucsf.edu.

Relationship Disclosure: Dr Kim has received research grants from the American Heart Association, the NIH, and SanBio, Inc; has served as an expert witness providing record review in a court case; and has received an honorarium and travel expenses for speaking at an American Neurological Association training course.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Kim reports no disclosure.

© 2014 American Academy of Neurology