Cardiac Imaging After Ischemic Stroke or Transient Ischemic Attack

Abstract

Purpose of Review Cardiac imaging after ischemic stroke or transient ischemic attack (TIA) is used to identify potential sources of cardioembolism, to classify stroke etiology leading to changes in secondary stroke prevention, and to detect frequent comorbidities. This article summarizes the latest research on this topic and provides an approach to clinical practice to use cardiac imaging after stroke. Recent Findings Echocardiography remains the primary imaging method for cardiac work-up after stroke. Recent echocardiography studies further demonstrated promising results regarding the prediction of non-permanent atrial fibrillation after ischemic stroke. Cardiac magnetic resonance imaging and computed tomography have been tested for their diagnostic value, in particular in patients with cryptogenic stroke, and can be considered as second line methods, providing complementary information in selected stroke patients. Summary Cardiac imaging after ischemic stroke or TIA reveals a potential causal condition in a subset of patients. Whether systematic application of cardiac imaging improves outcome after stroke remains to be established.

Rationale kardiale Diagnostik nach ischämischem Schlaganfall oder TIA

“…Die Mehrzahl der benannten kardialen Veränderungen lassen sich in der TEE diagnostizierenaufgrund der höheren Auflösung und des Schallfensters von transösophageal oder transgastral. Besser von transthorakal stellen sich (nach Echokontrastmittelapplikation) Ventrikelthromben dar [6]. Die TEE ist die ideale Methode für die Beurteilung des interatrialen Septums bzgl.…”

Effect of Cerebral Ischemic Strokes in Different Cerebral Artery Regions on Left Ventricular Function

“…The cardiac complications of strokes are dependent on their locations. Strokes of the insular lobe and basal ganglia, located in the middle cerebral artery (MCA) region, can lead to the loss of cardiac rhythm control, variability to fatal arrhythmias, and death ( 5 , 6 ). Thalamic strokes, located in the posterior cerebral artery (PCA) region, can cause disturbance of the autonomic nervous system in Takotsubo cardiomyopathy ( 7 ).…”

Cardiac imaging in ischemic stroke or transient ischemic attack of undetermined cause: Systematic review & meta-analysis

“…The choice of cardiac imaging technique is not a straightforward issue [15], as guidelines provide no consistent recommendations as to use transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE) [1,2,6,7]. While TTE is non-invasive and easily accessible, both the left atrial appendage (LAA) and ascending aorta can be better visualized with TEE [6,15]. Furthermore, cardiac computed tomography (CT) has been suggested as an alternative to echocardiography [16].…”