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Cardiol J ; 26(5): 438-450, 2019.
Article in English | MEDLINE | ID: mdl-29718528

ABSTRACT

Cardiogenic strokes comprised 11% of all strokes and 25% of ischemic strokes. An accurate identification of the cause of stroke is necessary in order to prepare an adequate preventive strategy. In this review the confirmed and potential causes of embolic strokes are presented, which can be detected in echocardiography in the context of present treatment guidelines and gaps in evidence. There remains a need for further studies assessing the meaning of potential cardiac sources of embolism and establishment of rules for optimal medical prevention (antiplatelet therapy [APT] vs. oral anticoagulation [OAC]) and interventional procedures to reduce the incidence of ischemic strokes. Currently available data does not provide definitive evidence on the comparative benefits of OAC vs. APT in patients with cryptogenic stroke or embolic stroke of undetermined source. There is a lack of antithrombotic treatment scheme in the time between stroke and the completed diagnosis of potential sources of thromboembolism.


Subject(s)
Brain Ischemia/etiology , Echocardiography , Embolism/diagnostic imaging , Heart Diseases/diagnostic imaging , Stroke/etiology , Adolescent , Adult , Aged , Anticoagulants/therapeutic use , Brain Ischemia/diagnostic imaging , Brain Ischemia/therapy , Clinical Decision-Making , Embolism/complications , Embolism/therapy , Endovascular Procedures , Female , Fibrinolytic Agents/therapeutic use , Heart Diseases/complications , Heart Diseases/therapy , Humans , Male , Middle Aged , Patient Selection , Platelet Aggregation Inhibitors/therapeutic use , Predictive Value of Tests , Risk Factors , Stroke/diagnostic imaging , Stroke/therapy , Treatment Outcome , Young Adult
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