Diagnosis of Cardioembolic Stroke

pp 491-494

Abstract

Although emboli to the brain often arise from dis-eases of the heart, the diagnosis of cardioembolic stroke can be often difficult. Neurologic features and the results of imaging of the brain are not very specific for cardioembolism. In addition, not all strokes that occur in persons with heart disease are secondary to cardioembolism. Some cardiac lesions are associated with a higher risk of embolism to the brain than others. Among the highest risk cardiac disease are rheumatic mitral stenosis associated with atrial fibrillation, acute myocardial infarction, prosthetic heart valves, and infective endocarditis. Conversely, the risk of stroke among persons with commonly detected cardiac abnormalities such as a patent foramen oval, atrial septal aneurysm, or mitral valve prolapse needs to be clarified. The use of diagnostic studies, such as transesophageal echocardiography, should help in the diagnosis of cardioembolic stroke.