Ischemic stroke echocardiography: Difference between revisions

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Latest revision as of 14:58, 12 January 2023

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S [2]

Overview

Echocardiography may be performed to determine the underlying etiology such as arrhythmias and the resultant clots in the heart that may spread to the brain vessels through the bloodstream.^[1]^[2]

Echocardiography

Echocardiography may help assess the structural cause and source of emboli in ischemic stroke.^[1]^[2]
It may also help assess risk factors for recurrent stroke such as atrial fibrillation, valvular heart disease and atherosclerosis.^[1]^[2]^[3]

2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association^[4]

Recommendations for Diagnostic Evaluation Referenced studies that support recommendations are summarized in online Data Supplements 1 and 2

Class IIa
6. In patients with cryptogenic stroke, echocardiography with or without contrast is reason-able to evaluate for possible cardiac sources of or transcardiac pathways for cerebral embolism.(Level of Evidence: B-R)

Class IIb
13. In patients with ESUS, transesophageal echocardiography (TEE), cardiac CT, or cardiac MRI might be reasonable to identify possible cardioaortic sources of or transcardiac pathways for cerebral embolism.(Level of Evidence: C-LD) 14. In patients with ischemic stroke or TIA in whom patent foramen ovale (PFO) closure would be contemplated, TCD (transcranial Doppler) with embolus detection might be reasonable to screen for right-to-left shunt.(Level of Evidence: C-LD)

For AHA/ASA guidelines for cardiac monitoring in patients with ischemic stroke, please click here

References

↑ ^1.0 ^1.1 ^1.2 de Abreu TT, Mateus S, Carreteiro C, Correia J (2008). "Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients". Vasc Health Risk Manag. 4 (1): 167–72. PMC 2464746. PMID 18629351.
↑ ^2.0 ^2.1 ^2.2 Ustrell X, Pellisé A (2010). "Cardiac workup of ischemic stroke". Curr Cardiol Rev. 6 (3): 175–83. doi:10.2174/157340310791658721. PMC 2994109. PMID 21804776.
↑ Kolo PM, Sanya EO, Omotosho AB, Chijoke A, Dada SA (2010). "The role of echocardiography in the management of stroke". West Afr J Med. 29 (4): 239–43. PMID 20931511.
↑ Kleindorfer DO, Towfighi A, Chaturvedi S, Cockroft KM, Gutierrez J, Lombardi-Hill D; et al. (2021). "2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association". Stroke. 52 (7): e364–e467. doi:10.1161/STR.0000000000000375. PMID 34024117 Check |pmid= value (help).

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[pmid18629351-1] 1.0 ^1.1 ^1.2 de Abreu TT, Mateus S, Carreteiro C, Correia J (2008). "Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients". Vasc Health Risk Manag. 4 (1): 167–72. PMC 2464746. PMID 18629351.

[pmid21804776-2] 2.0 ^2.1 ^2.2 Ustrell X, Pellisé A (2010). "Cardiac workup of ischemic stroke". Curr Cardiol Rev. 6 (3): 175–83. doi:10.2174/157340310791658721. PMC 2994109. PMID 21804776.

[pmid20931511-3] Kolo PM, Sanya EO, Omotosho AB, Chijoke A, Dada SA (2010). "The role of echocardiography in the management of stroke". West Afr J Med. 29 (4): 239–43. PMID 20931511.

[pmid34024117-4] Kleindorfer DO, Towfighi A, Chaturvedi S, Cockroft KM, Gutierrez J, Lombardi-Hill D; et al. (2021). "2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association". Stroke. 52 (7): e364–e467. doi:10.1161/STR.0000000000000375. PMID 34024117 Check |pmid= value (help).

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 __NOTOC__
-{{Stroke}}
+{{Ischemic stroke}}
+{{CMG}}{{AE}}{{AA}}
-Please help WikiDoc by adding more content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]]  to learn about editing.
-{{CMG}}
 ==Overview==
-Echocardiography may be performed to determine the underlying etiology such as arrhythmias and the resultant clots in the heart that may spread to the brain vessels through the bloodstream.
+Echocardiography may be performed to determine the underlying etiology such as arrhythmias and the resultant clots in the heart that may spread to the brain vessels through the bloodstream.<ref name="pmid18629351">{{cite journal| author=de Abreu TT, Mateus S, Carreteiro C, Correia J| title=Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients. | journal=Vasc Health Risk Manag | year= 2008 | volume= 4 | issue= 1 | pages= 167-72 | pmid=18629351 | doi= | pmc=2464746 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18629351  }} </ref><ref name="pmid21804776">{{cite journal| author=Ustrell X, Pellisé A| title=Cardiac workup of ischemic stroke. | journal=Curr Cardiol Rev | year= 2010 | volume= 6 | issue= 3 | pages= 175-83 | pmid=21804776 | doi=10.2174/157340310791658721 | pmc=2994109 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21804776  }} </ref>
 ==Echocardiography==
+*Echocardiography may help assess the structural cause and source of emboli in ischemic stroke.<ref name="pmid18629351">{{cite journal| author=de Abreu TT, Mateus S, Carreteiro C, Correia J| title=Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients. | journal=Vasc Health Risk Manag | year= 2008 | volume= 4 | issue= 1 | pages= 167-72 | pmid=18629351 | doi= | pmc=2464746 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18629351  }} </ref><ref name="pmid21804776">{{cite journal| author=Ustrell X, Pellisé A| title=Cardiac workup of ischemic stroke. | journal=Curr Cardiol Rev | year= 2010 | volume= 6 | issue= 3 | pages= 175-83 | pmid=21804776 | doi=10.2174/157340310791658721 | pmc=2994109 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21804776  }} </ref>
+*It may also help assess risk factors for recurrent stroke such as [[atrial fibrillation]], valvular heart disease and atherosclerosis.<ref name="pmid18629351">{{cite journal| author=de Abreu TT, Mateus S, Carreteiro C, Correia J| title=Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients. | journal=Vasc Health Risk Manag | year= 2008 | volume= 4 | issue= 1 | pages= 167-72 | pmid=18629351 | doi= | pmc=2464746 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18629351  }} </ref><ref name="pmid21804776">{{cite journal| author=Ustrell X, Pellisé A| title=Cardiac workup of ischemic stroke. | journal=Curr Cardiol Rev | year= 2010 | volume= 6 | issue= 3 | pages= 175-83 | pmid=21804776 | doi=10.2174/157340310791658721 | pmc=2994109 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21804776  }} </ref><ref name="pmid20931511">{{cite journal| author=Kolo PM, Sanya EO, Omotosho AB, Chijoke A, Dada SA| title=The role of echocardiography in the management of stroke. | journal=West Afr J Med | year= 2010 | volume= 29 | issue= 4 | pages= 239-43 | pmid=20931511 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20931511  }} </ref>
+== 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association<ref name="pmid34024117">{{cite journal| author=Kleindorfer DO, Towfighi A, Chaturvedi S, Cockroft KM, Gutierrez J, Lombardi-Hill D | display-authors=etal| title=2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association. | journal=Stroke | year= 2021 | volume= 52 | issue= 7 | pages= e364-e467 | pmid=34024117 | doi=10.1161/STR.0000000000000375 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34024117  }}</ref> ==
+=== Recommendations for Diagnostic Evaluation Referenced studies that support recommendations are summarized in online Data Supplements 1 and 2 ===
+{| class="wikitable"
+|-
+| colspan="1" style="text-align:center; background:LemonChiffon" |[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
+|-
+| bgcolor="LemonChiffon" |6.     In patients with cryptogenic stroke, echocardiography with or without contrast is reason-able to evaluate for possible cardiac sources of or transcardiac pathways for cerebral embolism.([[ACC AHA guidelines classification scheme#Level of Evidence|''Level of Evidence: B-R'']])
+|}
+{| class="wikitable"
+|-
+| colspan="1" style="text-align:center; background:LemonChiffon" |[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
+|-
+| bgcolor="LemonChiffon" |13.  In patients with ESUS, transesophageal echocardiography (TEE), cardiac CT, or cardiac MRI might be reasonable to identify possible cardioaortic sources of or transcardiac pathways for cerebral embolism.([[ACC AHA guidelines classification scheme#Level of Evidence|''Level of Evidence: C-LD'']])
+.   In patients with ischemic stroke or TIA in whom patent foramen ovale (PFO) closure would be contemplated, TCD (transcranial Doppler) with embolus detection might be reasonable to screen for right-to-left shunt.([[ACC AHA guidelines classification scheme#Level of Evidence|''Level of Evidence: C-LD'']])
+|}
+'''For AHA/ASA guidelines for cardiac monitoring in patients with ischemic stroke, please''' [[AHA/ASA guideline recommendations for of Early management of acute ischemic stroke#General Supportive Care and Treatment of Acute Complications|click here]]
 ==References==
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-[[Category:Aging-associated diseases]]
-[[Category:Cardiovascular diseases]]
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-[[Category:Cardiology]]
-[[Category:Neurosurgery]]
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