Prevention of ischemic stroke: antithrombotic therapy in cardiac embolism.

Ischemic stroke secondary to cardiac disease accounts for approximately 30% of all stroke subtypes and it may be due to a large list of conditions. Stroke secondary to heart disease causes more severe deficits, higher mortality, and increased costs that other stroke subtypes. Therefore, proper identification of cardioembolic stroke is crucial for adequate selection of optimal preventive strategies. Identification of stroke prone individuals with heart disease could also have an important therapeutic impact. This manuscript reviews the interaction between the heart and brain with a particularly emphasis in the current state of older and newer antithrombotic drugs for stroke prevention in patients with atrial fibrillation. Other neuro-cardiological issues reviewed include current antithrombotic strategies in patients with a host of heart conditions which include pacemakers, acute myocardial infarction, congestive heart failure, cardiac procedures, patent foramen ovale, valve disease, endocarditis, or cardiac tumours.