Acute cardioembolic stroke: an update

Abstract

Cardioembolic infarction is the most severe ischemic stroke subtype, but some clinical characteristics of the disease are still poorly defined. An update of relevant aspects related to clinical manifestations, biological characteristics, prognostic implications and treatment is presented in this article. Topics discussed include epidemiology and risk factors, clinical features and prognosis, cardiac work-up studies, patent foramen ovale, complex atheromatosis of the aortic arch, blood biomarkers, heart failure, and thrombolytic and anti-thrombotic therapy. Cardioembolic infarction is an important topic at the frontier between cardiology and vascular neurology, occurs frequently in daily practice, has a high impact for patients, healthcare systems and society, and merits an updated review of current clinical issues, advances and controversies.

Keywords::

• atrial fibrillation
• cardioembolic stroke
• heart failure
• oral anticoagulation
• patent foramen ovale
• plasma biomarkers

Acknowledgements

The authors thank Marta Pulido for her editorial assistance. Xavier Ustrell, Ramon Pujadas and Isidre Ferrer kindly provided some of the images included in this article from their files.

Financial & competing interests disclosure

The study was supported in part by a grant from Fondo de Investigación Sanitaria (FIS PI081514), Instituto de Salud Carlos III (Madrid, Spain). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Notes

Data taken from [4,6,12].