TY - CHAP M1 - Book, Section TI - Cerebrovascular Disease A1 - Aparicio, Hugo J. A1 - Lioutas, Vasileios-Arsenios A1 - Nguyen, Thanh N. A1 - Seshadri, Sudha A2 - Fuster, Valentin A2 - Narula, Jagat A2 - Vaishnava, Prashant A2 - Leon, Martin B. A2 - Callans, David J. A2 - Rumsfeld, John S. A2 - Poppas, Athena PY - 2022 T2 - Fuster and Hurst's The Heart, 15e AB - Chapter SummaryThis chapter discusses the classification, pathophysiology, epidemiology, genetics, treatment, and outcomes of stroke and cerebrovascular disease, with an emphasis on cerebrovascular complications of heart disease (see Fuster and Hurst’s Central Illustration). Modifiable and nonmodifiable risk factors for stroke overlap with those for ischemic heart disease, including hypertension, diabetes, smoking, age, family history, and certain genetic factors. Heart disease can cause cerebrovascular injury due to embolism of material from the heart, embolism via a right-to-left shunt, and hypoperfusion of the brain resulting from cardiac dysfunction or arrest. The most common etiologies for cardioembolism are atrial fibrillation with thromboembolism from the left atria or left atrial appendage, intracardiac thrombus following anterior myocardial infarction or in the setting of cardiomyopathy, and valvular heart disease causing embolism of thrombotic or infective material. The diagnostic evaluation of cardioembolic stroke includes brain imaging, examination of the blood vessels supplying the brain, electrocardiogram (ECG), and echocardiography (echo). A major focus of acute ischemic stroke management is treatment with intravenous (IV) thrombolysis and the use of endovascular therapy to treat emergent large vessel occlusion stroke. The chapter also discusses secondary stroke prevention using antiplatelet medication and the management of anticoagulation in the setting of intracerebral hemorrhage. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accesscardiology.mhmedical.com/content.aspx?aid=1202445052 ER -