RT Book, Section
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
SR Print(0)
ID 1202445052
T1 Cerebrovascular Disease
T2 Fuster and Hurst's The Heart, 15e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264257560
LK accesscardiology.mhmedical.com/content.aspx?aid=1202445052
RD 2024/04/20
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.