Recommendations for echocardiography use in the diagnosis and management of cardiac sources of embolism: European Association of Echocardiography (EAE) (a registered branch of the ESC).
Embolism of cardiac origin accounts for around 15-30% of ischaemic strokes. Strokes due to cardioembolism are generally severe and early and long-term recurrence and mortality are high. The diagnosis of a cardioembolic source of stroke is frequently uncertain and relies on the identification of a potential cardiac source of embolism in the absence of significant autochthone cerebrovascular occlusive disease. In this respect, echocardiography (both transthoracic and/or transoesophageal) serves as a cornerstone in the evaluation, diagnosis, and management of these patients. A clear understanding of the various types of cardiac conditions associated with cardioembolic stroke and their intrinsic risk is therefore very important. This article reviews potential cardiac sources of embolism and discusses the role of echocardiography in clinical practice. Recommendations for the use of echocardiography in the diagnosis of cardiac sources of embolism are given including major and minor conditions associated with the risk of embolism.
Pepi
Mauro
M
Centro Cardiologico Monzino, IRCCS, Department Cardiovascular Sciences, University of Milan, Via Parea 4, 20138 Milan, Italy. mauro.pepi@ccfm.it
Evangelista
Arturo
A
Nihoyannopoulos
Petros
P
Flachskampf
Frank A
FA
Athanassopoulos
George
G
Colonna
Paolo
P
Habib
Gilbert
G
Ringelstein
E Bernd
EB
Sicari
Rosa
R
Zamorano
Jose Luis
JL
Sitges
Marta
M
Caso
Pio
P
D001281:Atrial Fibrillation / Q000150:complications; D002318:Cardiovascular Diseases / Q000150:complications*; D004452:Echocardiography / Q000295:instrumentation; D017548:Echocardiography, Transesophageal / Q000295:instrumentation; D004617:Embolism / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D005060:Europe; D054092:Foramen Ovale, Patent / Q000150:complications; D006333:Heart Failure / Q000150:complications; D006801:Humans; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D009203:Myocardial Infarction / Q000150:complications; D018570:Risk Assessment; D012307:Risk Factors; D012955:Societies, Medical; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D014481:United States