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Embolic stroke

MedGen UID:
537428
•Concept ID:
C0262469
•
Disease or Syndrome
Synonyms: Embolic Stroke; Embolic Strokes; Stroke, Embolic; Strokes, Embolic
SNOMED CT: Embolic stroke (371041009)

Definition

An ischemic stroke due to a blood clot, emboli or other types of blockage which forms somewhere other than the brain and subsequently travels near and restricts blood flow to the brain. Most often the origin of the clot is from the heart and is referred to as cardioembolic stroke. [from MeSH]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVEmbolic stroke

Professional guidelines

PubMed

When Direct Oral Anticoagulants Should Not Be Standard Treatment: JACC State-of-the-Art Review.
Bejjani A, Khairani CD, Assi A, Piazza G, Sadeghipour P, Talasaz AH, Fanikos J, Connors JM, Siegal DM, Barnes GD, Martin KA, Angiolillo DJ, Kleindorfer D, Monreal M, Jimenez D, Middeldorp S, Elkind MSV, Ruff CT, Goldhaber SZ, Krumholz HM, Mehran R, Cushman M, Eikelboom JW, Lip GYH, Weitz JI, Lopes RD, Bikdeli B
J Am Coll Cardiol 2024 Jan 23;83(3):444-465. doi: 10.1016/j.jacc.2023.10.038. PMID: 38233019
Management of Hypertrophic Cardiomyopathy: JACC State-of-the-Art Review.
Maron BJ, Desai MY, Nishimura RA, Spirito P, Rakowski H, Towbin JA, Dearani JA, Rowin EJ, Maron MS, Sherrid MV
J Am Coll Cardiol 2022 Feb 1;79(4):390-414. doi: 10.1016/j.jacc.2021.11.021. PMID: 35086661
Anticoagulation management in haemodialysis patients with atrial fibrillation: evidence and opinion.
De Vriese AS, Heine G
Nephrol Dial Transplant 2022 Oct 19;37(11):2072-2079. doi: 10.1093/ndt/gfab060. PMID: 33647941

Recent clinical studies

Etiology

Recurrent Ischemic Stroke - A Systematic Review and Meta-Analysis.
Kolmos M, Christoffersen L, Kruuse C
J Stroke Cerebrovasc Dis 2021 Aug;30(8):105935. Epub 2021 Jun 18 doi: 10.1016/j.jstrokecerebrovasdis.2021.105935. PMID: 34153594
Atrial Fibrillation and Stroke.
Essa H, Hill AM, Lip GYH
Card Electrophysiol Clin 2021 Mar;13(1):243-255. doi: 10.1016/j.ccep.2020.11.003. PMID: 33516402
Sleep Duration and Stroke: Prospective Cohort Study and Mendelian Randomization Analysis.
Titova OE, Michaëlsson K, Larsson SC
Stroke 2020 Nov;51(11):3279-3285. Epub 2020 Sep 8 doi: 10.1161/STROKEAHA.120.029902. PMID: 32895015Free PMC Article
Embolic Stroke of Undetermined Source: JACC Review Topic of the Week.
Ntaios G
J Am Coll Cardiol 2020 Jan 28;75(3):333-340. doi: 10.1016/j.jacc.2019.11.024. PMID: 31976872
Cardioembolic Stroke.
Kamel H, Healey JS
Circ Res 2017 Feb 3;120(3):514-526. doi: 10.1161/CIRCRESAHA.116.308407. PMID: 28154101Free PMC Article

Diagnosis

Diagnosis and Management of Cardioembolic Stroke.
Yaghi S
Continuum (Minneap Minn) 2023 Apr 1;29(2):462-485. doi: 10.1212/CON.0000000000001217. PMID: 37039405
Review and update of the concept of embolic stroke of undetermined source.
Diener HC, Easton JD, Hart RG, Kasner S, Kamel H, Ntaios G
Nat Rev Neurol 2022 Aug;18(8):455-465. Epub 2022 May 10 doi: 10.1038/s41582-022-00663-4. PMID: 35538232
Recurrent Ischemic Stroke - A Systematic Review and Meta-Analysis.
Kolmos M, Christoffersen L, Kruuse C
J Stroke Cerebrovasc Dis 2021 Aug;30(8):105935. Epub 2021 Jun 18 doi: 10.1016/j.jstrokecerebrovasdis.2021.105935. PMID: 34153594
Embolic Stroke of Undetermined Source: JACC Review Topic of the Week.
Ntaios G
J Am Coll Cardiol 2020 Jan 28;75(3):333-340. doi: 10.1016/j.jacc.2019.11.024. PMID: 31976872
Cardioembolic Stroke.
Kamel H, Healey JS
Circ Res 2017 Feb 3;120(3):514-526. doi: 10.1161/CIRCRESAHA.116.308407. PMID: 28154101Free PMC Article

Therapy

When Direct Oral Anticoagulants Should Not Be Standard Treatment: JACC State-of-the-Art Review.
Bejjani A, Khairani CD, Assi A, Piazza G, Sadeghipour P, Talasaz AH, Fanikos J, Connors JM, Siegal DM, Barnes GD, Martin KA, Angiolillo DJ, Kleindorfer D, Monreal M, Jimenez D, Middeldorp S, Elkind MSV, Ruff CT, Goldhaber SZ, Krumholz HM, Mehran R, Cushman M, Eikelboom JW, Lip GYH, Weitz JI, Lopes RD, Bikdeli B
J Am Coll Cardiol 2024 Jan 23;83(3):444-465. doi: 10.1016/j.jacc.2023.10.038. PMID: 38233019
Ischemic Stroke.
Feske SK
Am J Med 2021 Dec;134(12):1457-1464. Epub 2021 Aug 27 doi: 10.1016/j.amjmed.2021.07.027. PMID: 34454905
Atrial Fibrillation and Ischemic Stroke: A Clinical Review.
Migdady I, Russman A, Buletko AB
Semin Neurol 2021 Aug;41(4):348-364. Epub 2021 Apr 13 doi: 10.1055/s-0041-1726332. PMID: 33851396
Atrial Fibrillation and Stroke.
Essa H, Hill AM, Lip GYH
Card Electrophysiol Clin 2021 Mar;13(1):243-255. doi: 10.1016/j.ccep.2020.11.003. PMID: 33516402
Embolic Stroke of Undetermined Source: JACC Review Topic of the Week.
Ntaios G
J Am Coll Cardiol 2020 Jan 28;75(3):333-340. doi: 10.1016/j.jacc.2019.11.024. PMID: 31976872

Prognosis

Apixaban versus Aspirin for Embolic Stroke of Undetermined Source.
Geisler T, Keller T, Martus P, Poli K, Serna-Higuita LM, Schreieck J, Gawaz M, Tünnerhoff J, Bombach P, Nägele T, Klose U, Aidery P, Groga-Bada P, Kraft A, Hoffmann F, Hobohm C, Naupold K, Niehaus L, Wolf M, Bäzner H, Liman J, Wachter R, Kimmig H, Jung W, Huber R, Feurer R, Lindner A, Althaus K, Bode FJ, Petzold GC, Nguyen TN, Mac Grory B, Schrag M, Purrucker JC, Zuern CS, Ziemann U, Poli S; ATTICUS Investigators
NEJM Evid 2024 Jan;3(1):EVIDoa2300235. Epub 2023 Dec 22 doi: 10.1056/EVIDoa2300235. PMID: 38320511
Evaluating Rates of Recurrent Ischemic Stroke Among Young Adults With Embolic Stroke of Undetermined Source: The Young ESUS Longitudinal Cohort Study.
Perera KS, de Sa Boasquevisque D, Rao-Melacini P, Taylor A, Cheng A, Hankey GJ, Lee S, Fabregas JM, Ameriso SF, Field TS, Arauz A, Coutts SB, Arnold M, Mikulik R, Toni D, Mandzia J, Veltkamp RC, Meseguer E, Haeusler KG, Hart RG; Young ESUS Investigators
JAMA Neurol 2022 May 1;79(5):450-458. doi: 10.1001/jamaneurol.2022.0048. PMID: 35285869Free PMC Article
Recurrent Ischemic Stroke - A Systematic Review and Meta-Analysis.
Kolmos M, Christoffersen L, Kruuse C
J Stroke Cerebrovasc Dis 2021 Aug;30(8):105935. Epub 2021 Jun 18 doi: 10.1016/j.jstrokecerebrovasdis.2021.105935. PMID: 34153594
Cancer and Embolic Stroke of Undetermined Source.
Navi BB, Kasner SE, Elkind MSV, Cushman M, Bang OY, DeAngelis LM
Stroke 2021 Mar;52(3):1121-1130. Epub 2021 Jan 28 doi: 10.1161/STROKEAHA.120.032002. PMID: 33504187Free PMC Article
Hypertrophic cardiomyopathy: a systematic review.
Maron BJ
JAMA 2002 Mar 13;287(10):1308-20. doi: 10.1001/jama.287.10.1308. PMID: 11886323

Clinical prediction guides

Diagnosis and Management of Cardioembolic Stroke.
Yaghi S
Continuum (Minneap Minn) 2023 Apr 1;29(2):462-485. doi: 10.1212/CON.0000000000001217. PMID: 37039405
Recurrent Ischemic Stroke - A Systematic Review and Meta-Analysis.
Kolmos M, Christoffersen L, Kruuse C
J Stroke Cerebrovasc Dis 2021 Aug;30(8):105935. Epub 2021 Jun 18 doi: 10.1016/j.jstrokecerebrovasdis.2021.105935. PMID: 34153594
Atrial Fibrillation and Ischemic Stroke: A Clinical Review.
Migdady I, Russman A, Buletko AB
Semin Neurol 2021 Aug;41(4):348-364. Epub 2021 Apr 13 doi: 10.1055/s-0041-1726332. PMID: 33851396
Neuroinflammatory Mechanisms in Ischemic Stroke: Focus on Cardioembolic Stroke, Background, and Therapeutic Approaches.
Maida CD, Norrito RL, Daidone M, Tuttolomondo A, Pinto A
Int J Mol Sci 2020 Sep 4;21(18) doi: 10.3390/ijms21186454. PMID: 32899616Free PMC Article
Sleep Duration and Stroke: Prospective Cohort Study and Mendelian Randomization Analysis.
Titova OE, Michaëlsson K, Larsson SC
Stroke 2020 Nov;51(11):3279-3285. Epub 2020 Sep 8 doi: 10.1161/STROKEAHA.120.029902. PMID: 32895015Free PMC Article

Recent systematic reviews

Electrocardiographic Predictors of Atrial Fibrillation.
Chousou PA, Chattopadhyay R, Tsampasian V, Vassiliou VS, Pugh PJ
Med Sci (Basel) 2023 Apr 7;11(2) doi: 10.3390/medsci11020030. PMID: 37092499Free PMC Article
Management of Hypertrophic Cardiomyopathy: JACC State-of-the-Art Review.
Maron BJ, Desai MY, Nishimura RA, Spirito P, Rakowski H, Towbin JA, Dearani JA, Rowin EJ, Maron MS, Sherrid MV
J Am Coll Cardiol 2022 Feb 1;79(4):390-414. doi: 10.1016/j.jacc.2021.11.021. PMID: 35086661
Recurrent Ischemic Stroke - A Systematic Review and Meta-Analysis.
Kolmos M, Christoffersen L, Kruuse C
J Stroke Cerebrovasc Dis 2021 Aug;30(8):105935. Epub 2021 Jun 18 doi: 10.1016/j.jstrokecerebrovasdis.2021.105935. PMID: 34153594
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and cardiac arrhythmias: a systematic review and meta-analysis.
Li HL, Lip GYH, Feng Q, Fei Y, Tse YK, Wu MZ, Ren QW, Tse HF, Cheung BY, Yiu KH
Cardiovasc Diabetol 2021 May 7;20(1):100. doi: 10.1186/s12933-021-01293-8. PMID: 33962654Free PMC Article
Hypertrophic cardiomyopathy: a systematic review.
Maron BJ
JAMA 2002 Mar 13;287(10):1308-20. doi: 10.1001/jama.287.10.1308. PMID: 11886323

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