Suspected Cardioembolic Stroke
Also known as: Embolic Stroke of Undetermined Source (ESUS)
Suspected cardioembolic stroke is a type of ischemic stroke caused by a blood clot that originates from the heart and travels to the brain, blocking blood flow to a part of the brain. It occurs when a clot forms in the heart, often due to an underlying heart condition or abnormal heart rhythm (arrhythmia), such as atrial fibrillation. The clot can break loose from the heart and travel through the bloodstream until it lodges in a blood vessel in the brain, leading to a stroke.
What are the symptoms of Suspected Cardioembolic Stroke?
The symptoms of suspected cardioembolic stroke are similar to those of other types of stroke and may include:
Sudden weakness or numbness, typically on one side of the body.
Difficulty speaking or understanding speech.
Confusion or sudden changes in mental status.
Vision problems, such as blurred or double vision.
Difficulty walking, loss of balance, or coordination problems.
Severe headache, often accompanied by dizziness or nausea.
Facial drooping or asymmetry.
Loss of consciousness or fainting.
How is Suspected Cardioembolic Stroke diagnosed?
Diagnosis of suspected cardioembolic stroke typically involves a combination of medical history, physical examination, and diagnostic tests, which may include:
Auscultation:
Listening to the heart sounds using a stethoscope to detect abnormal heart murmurs or other sounds indicative of valve dysfunction.
Echocardiogram:
This non-invasive ultrasound test provides images of the heart's structure and function, helping to assess for the presence of blood clots, abnormal heart valves, or other conditions that may increase the risk of stroke.
Electrocardiogram (ECG or EKG):
This non-invasive test records the electrical activity of the heart and can detect abnormal heart rhythms (arrhythmias) such as atrial fibrillation, which increases the risk of cardioembolic stroke.
Neurological Examination:
A healthcare provider will assess symptoms, including strength, sensation, coordination, and mental status, to determine the likelihood of a stroke.
Imaging Tests:
Imaging tests such as computed tomography (CT) or magnetic resonance imaging (MRI) scans of the brain can provide detailed images of the brain to identify areas of damage or abnormalities consistent with a stroke.
Blood Tests:
Blood tests may be performed to assess levels of certain biomarkers associated with stroke, as well as to evaluate blood clotting function and screen for underlying medical conditions that may contribute to stroke risk.
How is Suspected Cardioembolic Stroke treated?
Treatment for suspected cardioembolic stroke aims to restore blood flow to the affected part of the brain, prevent further damage, and reduce the risk of future strokes. Treatment options may include:
Intravenous Thrombolysis:
This medication, known as tissue plasminogen activator (tPA), may be administered within a few hours of stroke onset to dissolve the blood clot and restore blood flow to the brain.
Mechanical Thrombectomy:
In some cases, a minimally invasive procedure called mechanical thrombectomy may be performed to remove the blood clot from the blocked blood vessel using a specialised device inserted through a catheter.
Anticoagulant Therapy:
Anticoagulant medications such as warfarin, dabigatran, rivaroxaban, apixaban, or edoxaban may be prescribed to prevent the formation of blood clots in the heart and reduce the risk of recurrent stroke in patients with atrial fibrillation or other cardioembolic sources.
Antiplatelet Therapy:
Antiplatelet medications such as aspirin, clopidogrel, or dipyridamole may be prescribed to prevent blood clotting and reduce the risk of recurrent stroke in patients with certain types of ischemic stroke.
Management of underlying heart conditions:
Treatment of underlying heart conditions such as atrial fibrillation, heart valve disorders, or heart failure may be necessary to reduce the risk of future cardioembolic strokes.
Individuals who experience suspected cardioembolic stroke should seek immediate medical attention to receive prompt evaluation and treatment. Early intervention is crucial for optimising outcomes and minimising the risk of disability or complications associated with stroke. Following a stroke, rehabilitation therapy and lifestyle modifications may also be recommended to help improve recovery, regain function, and reduce the risk of recurrent stroke
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