Cardiac Embolism: Identification, Symptoms, Seeking Medical Assistance, and Management Strategies
Cardioembolic strokes, a type of ischemic stroke, are caused by emboli (clots or debris) originating from the heart and blocking brain vessels. These strokes can lead to sudden focal neurological deficits, such as weakness, speech disturbance, or visual changes.
Atrial fibrillation, a common heart condition, is the leading cardiac cause of cardioembolic strokes due to the formation of blood clots in the atria. Other cardiac causes include infective endocarditis, aortic dissection, aortic aneurysm, heart valve diseases, and subtle left ventricular dysfunction.
Risk factors for developing cardioembolic strokes include both nonmodifiable factors like age, sex, ethnicity, and genetics, and modifiable ones such as hypertension, diabetes, smoking, obesity, and sedentary lifestyle. Cardiac factors like atrial fibrillation and other cardiac abnormalities also increase the risk. Inflammation and hypercoagulable states, including those triggered by infections like COVID-19 or malignancy-related coagulation disturbances, also play a role.
Symptoms of cardioembolic strokes align with typical ischemic stroke presentations, involving acute loss of neurological function based on the brain area affected. This includes sudden weakness or numbness on one side, difficulty speaking or understanding speech, vision problems, dizziness, or loss of coordination.
Prevention is key in managing cardioembolic strokes. Controlling risk factors such as atrial fibrillation, hypertension, and underlying cardiac disease is critical. Procedures like catheter ablation, which destroys small amounts of heart tissue causing atrial fibrillation, and left atrial appendage closure, which helps prevent blood from collecting and clotting, can also be beneficial.
Early recognition and treatment can improve outcomes. Anyone experiencing symptoms of cardioembolic stroke should seek immediate medical advice. Even those without symptoms may want to speak with a doctor if they have a condition that increases their risk of strokes.
Diagnostic tools such as MRI and CT scans, carotid ultrasound, and blood tests can help identify cardioembolic strokes and assess for damage to the heart muscle. Treatment may involve electrical cardioversion to restart the heart's normal rhythm, and management of the underlying causes.
The outlook for people who have had a cardioembolic stroke varies greatly, depending on the severity of the stroke, how quickly the individual receives treatment, the treatment for the underlying causes, and the risk of having another stroke.
[1] Mayo Clinic. (2021). Cardioembolic stroke. [online] Available at: https://www.mayoclinic.org/diseases-conditions/cardioembolic-stroke/symptoms-causes/syc-20356773 [2] American Heart Association. (2021). What is Atrial Fibrillation? [online] Available at: https://www.heart.org/en/health-topics/afib/what-is-atrial-fibrillation [3] NHS. (2021). Stroke. [online] Available at: https://www.nhs.uk/conditions/stroke/ [4] American Academy of Neurology. (2021). Cardioembolic stroke in young adults. [online] Available at: https://www.aan.com/patients/disease-information/cardioembolic-stroke-in-young-adults [5] Cleveland Clinic. (2021). Cardioembolic Stroke. [online] Available at: https://my.clevelandclinic.org/health/diseases/16788-cardioembolic-stroke
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