Peter M, Rickenbacher P, Burckhardt D
Abteilung für Kardiologie, Kantonsspital, Basel.
Schweiz Rundsch Med Prax. 1992 Dec 15;81(51):1538-42.
Cerebral embolism originating from the heart accounts for approximately 15 to 20% of ischemic strokes. By far the most important source for cardiac embolism is associated with atrial fibrillation; in these patients immediate anticoagulation with no further echocardiographic diagnostic is recommended. The majority of the remaining cardiac sources of embolism--they originate from the left ventricle and the valves--can be suggested by clinical signs. In these cases a documentation by echocardiography is indicated. In contrast, embolism originating from the left atrium is rare and commonly not detectable by simple clinical means. The semi-invasive transesophageal echocardiography is able to visualize atrial pathologies with a high accuracy, but this investigation should be performed routinely only in patients less than 45 years old with no evidence for cardiac disease.
心源性脑栓塞约占缺血性卒中的15%至20%。迄今为止，心脏栓塞最重要的来源与心房颤动有关；对于这些患者，建议立即进行抗凝治疗，无需进一步的超声心动图诊断。其余大多数心脏栓塞来源——它们起源于左心室和瓣膜——可通过临床体征提示。在这些情况下，需要进行超声心动图检查。相比之下，起源于左心房的栓塞很少见，通常无法通过简单的临床方法检测到。半侵入性经食管超声心动图能够高精度地显示心房病变，但这项检查仅应常规用于年龄小于45岁且无心脏病证据的患者。
