Abstract
Despite increasing sophistication of brain imaging, neurovascular evaluation, and laboratory testing, a sizable proportion of ischemic strokes defy etiologic classification. Many, if not most, of such 'cryptogenic' strokes may stem from unrecognized cardiac or aortic embolism, with a bimodal pathophysiology potentially dominated by interatrial septal abnormalities in young adults, and by subclinical aortic and large-artery atherothrombotic embolism in older individuals. Echocardiography is the centerpiece of the diagnostic evaluation of unexplained ischemic stroke, and unless contraindicated, transesophageal echocardiography is currently the modality of choice. Comprehensive and timely evaluation is essential to identify the potential emboligenic substrate, and, pending randomized trial data, to institute appropriate therapy based on best clinical judgment.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 535-540 |
| Number of pages | 6 |
| Journal | Coronary Artery Disease |
| Volume | 19 |
| Issue number | 7 |
| DOIs | |
| State | Published - Nov 2008 |
| Externally published | Yes |
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Keywords
- Aortic atheroma
- Atrial septal anerusym
- Echocardiography
- Embolism
- Patent foramen ovale
- Stroke
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Evaluation of the patient with unexplained stroke. / Kizer, Jorge.
In: Coronary Artery Disease, Vol. 19, No. 7, 11.2008, p. 535-540.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Evaluation of the patient with unexplained stroke
AU - Kizer, Jorge
PY - 2008/11
Y1 - 2008/11
N2 - Despite increasing sophistication of brain imaging, neurovascular evaluation, and laboratory testing, a sizable proportion of ischemic strokes defy etiologic classification. Many, if not most, of such 'cryptogenic' strokes may stem from unrecognized cardiac or aortic embolism, with a bimodal pathophysiology potentially dominated by interatrial septal abnormalities in young adults, and by subclinical aortic and large-artery atherothrombotic embolism in older individuals. Echocardiography is the centerpiece of the diagnostic evaluation of unexplained ischemic stroke, and unless contraindicated, transesophageal echocardiography is currently the modality of choice. Comprehensive and timely evaluation is essential to identify the potential emboligenic substrate, and, pending randomized trial data, to institute appropriate therapy based on best clinical judgment.
AB - Despite increasing sophistication of brain imaging, neurovascular evaluation, and laboratory testing, a sizable proportion of ischemic strokes defy etiologic classification. Many, if not most, of such 'cryptogenic' strokes may stem from unrecognized cardiac or aortic embolism, with a bimodal pathophysiology potentially dominated by interatrial septal abnormalities in young adults, and by subclinical aortic and large-artery atherothrombotic embolism in older individuals. Echocardiography is the centerpiece of the diagnostic evaluation of unexplained ischemic stroke, and unless contraindicated, transesophageal echocardiography is currently the modality of choice. Comprehensive and timely evaluation is essential to identify the potential emboligenic substrate, and, pending randomized trial data, to institute appropriate therapy based on best clinical judgment.
KW - Aortic atheroma
KW - Atrial septal anerusym
KW - Echocardiography
KW - Embolism
KW - Patent foramen ovale
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=55749107633&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=55749107633&partnerID=8YFLogxK
U2 - 10.1097/MCA.0b013e32830eabb6
DO - 10.1097/MCA.0b013e32830eabb6
M3 - Article
C2 - 18923251
AN - SCOPUS:55749107633
VL - 19
SP - 535
EP - 540
JO - Coronary Artery Disease
JF - Coronary Artery Disease
SN - 0954-6928
IS - 7
ER -