Atrial Septal Defects and Cardioembolic Strokes

Michelle Leppert; Sharon N Poisson; John D Carroll

doi:10.1016/j.ccl.2015.12.004

Atrial Septal Defects and Cardioembolic Strokes

Cardiol Clin. 2016 May;34(2):225-30. doi: 10.1016/j.ccl.2015.12.004. Epub 2016 Mar 9.

Authors

Michelle Leppert¹, Sharon N Poisson¹, John D Carroll²

Affiliations

¹ Department of Neurology, University of Colorado Denver, 12631 East 17th Avenue, Aurora, CO 80045, USA.
² Department of Medicine University of Colorado Denver, Leprino Office Building on Anschutz Medical Campus, 12401 East 17th Avenue, Room 524, Mail Stop B132, Aurora, CO 80045, USA. Electronic address: John.carroll@ucdenver.edu.

PMID: 27150170
DOI: 10.1016/j.ccl.2015.12.004

Abstract

Atrial septal defects (ASDs) can be complicated by cardioembolic strokes, but the exact incidence is unknown. Patients with large and small shunts may present with a cardioembolic stroke. Patients with cryptogenic strokes should have cardiac ultrasound to see if an ASD is present. Cardioembolic strokes associated with ASD principally occur with 2 mechanisms. The first is paradoxic embolism involving a venous-based source of thrombus, which may subsequently pass through the ASD by right-to-left shunting, causing a cardioembolic stroke. The second is atrial fibrillation that can complicate the course of patients with ASDs, especially as they age.

Keywords: Atrial fibrillation; Atrial septal defect; Paradoxic embolism; Shunt; Stroke.

Publication types

Review

MeSH terms

Global Health
Heart Septal Defects, Atrial / complications*
Heart Septal Defects, Atrial / epidemiology
Humans
Incidence
Risk Factors
Stroke / epidemiology
Stroke / etiology*