Cardioembolic stroke
Cardioembolic stroke
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DOI：
10.1002/9781118492390.ch5c
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发表时间：
2019-01
期刊：
影响因子：
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通讯作者：
Issam A. Mikati;Zeina Ibrahim
中科院分区：
文献类型：
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作者：
Issam A. Mikati;Zeina Ibrahim
脑栓塞性卒中占所有缺血性卒中的15 - 40%，而隐源性卒中占其余脑梗死的30 - 40%。如果临床怀疑心脏肿块、心内膜炎或重新评估有进展风险或感染性心内膜炎并发症的高危个体，建议进行经胸超声心动图（TTE）检查。目前，计算机断层扫描血管造影（CTA）主要用于评估胸主动脉粥样硬化斑块的疾病负担程度。心源性卒中最常见的来源是位于左心耳（LAA）内的血栓。粘液瘤是最常见的原发性心脏肿瘤，多位于左心房。乳头状纤维瘤（PFE）是成人第二常见的原发性心脏肿瘤。各种瓣膜疾病，影响天然和人工心脏瓣膜，可导致全身和肺栓塞的发展。
Cardioembolic strokes account for 15‐40 percent of all ischemic strokes, and cryptogenic strokes account for an even higher 30‐40 percent of the remaining cerebral infarctions. Transthoracic echocardiography (TTE) is recommended if there is clinical suspicion of a cardiac mass, endocarditis or for re‐evaluation of high‐risk individuals with risk of progression or complication with infective endocarditis. Currently, computed tomography angiography (CTA) is mainly used to evaluate the thoracic aorta for atherosclerotic plaque in extent of burden of the disease. The most prevalent source of a cardioembolic stroke is a thrombus located within the left atrial appendage (LAA). Myxomas, the most common primary cardiac tumors, are mostly located in the left atrium. Papillary fibroelastomas (PFE) are the second most common primary cardiac tumor in adults. Various valvular disorders, affecting both native and prosthetic cardiac valves, can lead to the development of systemic and pulmonary embolus.