Cardiovascular causes of stroke
|Cardiovascular causes of stroke
Here are some important cardiovascular causes of stroke include:
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Atrial fibrillation / flutter
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Patent foramen ovale (PFO) with right to left shunt or atrial septal aneurysm
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Cardiomyopathy
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Aortic arch atheroma
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Valvular heart disease with intracardiac thrombi or vegetations
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Atrial myxoma and fibroelastoma
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Mural thrombus in myocardial infarction
Two recent trials (Gore REDUCE and CLOSE) [1,2] and long term outcome results of RESPECT trial [3] provide clear evidence for PFO closure for stroke prevention in those below 60 years with high risk – PFO. High risk PFO is one with substantial right to left shunting or an atrial septal aneurysm.
References
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Sondergaard L, Kasner SE, Rhodes JF, Andersen G, Iversen HK, Nielsen-Kudsk JE, Settergren M, Sjostrand C, Roine RO, Hildick-Smith D, Spence JD, Thomassen L; Gore REDUCE Clinical Study Investigators. Patent foramen ovale closure or antiplatelet therapy for cryptogenic stroke. N Engl J Med. 2017;377:1033–1042.
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Mas JL, Derumeaux G, Guillon B, Massardier E, Hosseini H, Mechtouff L, Arquizan C, Bejot Y, Vuillier F, Detante O, Guidoux C, Canaple S, Vaduva C, Dequatre-Ponchelle N, Sibon I, Garnier P, Ferrier A, Timsit S, Robinet-Borgomano E, Sablot D, Lacour JC, Zuber M, Favrole P, Pinel JF, Apoil M, Reiner P, Lefebvre C, Guérin P, Piot C, Rossi R, Dubois-Randé JL, Eicher JC, Meneveau N, Lusson JR, Bertrand B, Schleich JM, Godart F, Thambo JB, Leborgne L, Michel P, Pierard L, Turc G, Barthelet M, Charles-Nelson A, Weimar C, Moulin T, Juliard JM, Chatellier G; CLOSE Investigators. Patent foramen ovale closure or anticoagulation vs. antiplatelets after stroke. N Engl J Med. 2017;377:1011–1021.
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Saver JL, Carroll JD, Thaler DE, Smalling RW, MacDonald LA, Marks DS, Tirschwell DL; RESPECT Investigators. Long-term outcomes of patent foramen ovale closure or medical therapy after stroke. N Engl J Med. 2017;377:1022–1032.