[Ischemic cerebrovascular seizure: when and how should one search for a cardiac embolism source?].
Cerebral embolism originating from the heart accounts for approximately 15 to 20% of ischemic strokes. By far the most important source for cardiac embolism is associated with atrial fibrillation; in these patients immediate anticoagulation with no further echocardiographic diagnostic is recommended. The majority of the remaining cardiac sources of embolism--they originate from the left ventricle and the valves--can be suggested by clinical signs. In these cases a documentation by echocardiography is indicated. In contrast, embolism originating from the left atrium is rare and commonly not detectable by simple clinical means. The semi-invasive transesophageal echocardiography is able to visualize atrial pathologies with a high accuracy, but this investigation should be performed routinely only in patients less than 45 years old with no evidence for cardiac disease.
Peter
M
M
Abteilung für Kardiologie, Kantonsspital, Basel.
Rickenbacher
P
P
Burckhardt
D
D
D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis; D004452:Echocardiography; D004562:Electrocardiography; D006338:Heart Neoplasms / Q000150:complications; D006343:Heart Septal Defects / Q000150:complications; D006349:Heart Valve Diseases / Q000150:complications / Q000175:diagnosis; D006350:Heart Valve Prosthesis; D002542:Intracranial Embolism and Thrombosis / Q000209:etiology*; D009232:Myxoma / Q000150:complications; D013927:Thrombosis / Q000150:complications* / Q000175:diagnosis
Ischämischer zerebrovaskulärer Insult: Wann und wie soll eine kardiale Emboliequelle gesucht werden?