Cardioembolic Stroke:

Practical Considerations for Patient Risk Management and Secondary Prevention

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Hardik Amin, MD; Richard J. Nowak, MD, MS; Joseph L. Schindler, MD

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Postgraduate Medicine:

Volume 126 No. 1


Clinical Focus

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DOI: 10.3810/pgm.2014.01.2725
Abstract: Cardioembolic (CE) stroke constitutes approximately 20% of all occurrence of ischemic stroke in patients. Atrial fibrillation remains the most common and most studied mechanism underlying CE stroke events. Cardioembolic strokes carry high morbidity and are associated with early recurrence in patients. Our understanding of other patient mechanisms associated with CE stroke, including valvular disease, left ventricular dysfunction, and patent foramen ovale, continues to grow. Our review summarizes the diagnosis and management of patients who have sustained CE stroke as a result of the aforementioned cardiac mechanisms. Advances in primary and secondary risk management for prevention of CE stroke are also highlighted in our article—specifically, emerging data regarding monitoring of patients with atrial fibrillation, new anticoagulation therapy, and management of patients with decreased ejection fraction.

Keywords: cardioembolic stroke; risk management; secondary prevention; etiology