Stroke is a catastrophic event that can leave affected individual with deficit or even death. The deficit could range from inability to talk to inability to move one part of the body. Twenty million people worldwide experience a stroke each year. This makes it a leading cause of long-term disability and second-leading cause of death.
Two-third of stroke are due to ischemic stroke where as one-third represents bleeding into the brain. Ischemic stroke can be due to several causes, such as cholesterol deposit in the blood vessels of the brain or cardiac embolism. Cardioembolic stroke is important for two reasons. Firstly, it causes severe form of stroke compare to other causes of ischemic stroke. Secondly, the incidence of stroke due to other causes apart from cardioembolic stroke is reducing with increasing use of antihypertensives and cholesterol lowering medications. On the other hand, the incidence of cardioembolic stroke is on the rise.
In cardioembolic stroke, blood clots are pumped from the heart into the circulation. These blood clots are scattered causing widespread damage to the brain.
A number of risk factors can predispose to cardioembolic stroke.
Atrial fibrillation: This disorder of the rhythm of the heart makes the heart to beat irregularly. The irregular beat allows blood clot to form in the heart. The clot can break loose and cause cardioembolic stroke.
Heart failure with low ejection fraction: In this form of heart failure, the heart pumps less than 40% of the blood in its chambers into the circulation. This ineffective contraction causes stasis of blood and clot formation.
Recent heart attack: The part of the heart affected by heart attack may balloon out allowing blood clot to form. This can act as source of cardioembolic stroke
Patent foramen ovale: This is an abnormal opening between the right and left chamber of the heart. Ideally, the opening should not be patent after birth. In those with patent foramen ovale, the opening can allow passage of clot from the veins of the legs through the opening into the brain.
Prosthetic heart valves: Patients with artificial heart valves can develop blood clot on these valves when they are not on appropriate dosage of blood thinner.
There are other less common causes such as infective endocarditis, atrial myxoma and mitral calcification.
Cardioembolic stroke can be prevented by screening for these risk factors. Visit us at TAAL specialist hospital for cardiovascular screening for your evaluation.
