Nakanishi Koki, Homma Shunichi
Department of Medicine, Columbia University, New York, NY, USA.
Department of Medicine, Columbia University, New York, NY, USA.
J Cardiol. 2016 Aug;68(2):91-9. doi: 10.1016/j.jjcc.2016.05.001. Epub 2016 May 30.
Investigation of potential embolic source is an important diagnostic step in treating patients with ischemic stroke and transient ischemic attack. Cardiogenic embolism has been estimated to be the causative factor in 15-30% of all cases of ischemic stroke. Cardioembolic strokes are generally severe and recurrence and mortality rate high. Various cardiac disorders including atrial fibrillation, ventricular thrombus, valvular heart disease, cardiac tumors, and structural heart defects can cause cardioembolic stroke. Although the aortic arch is not a cardiac structure, it is usually considered under source of cardiac embolism (cardioaortic source) and is reviewed in this article. Echocardiography (both transthoracic and transesophageal) is a widely used and versatile technique that can provide comprehensive information of thromboembolic risk in patients with stroke. This article reviews potential cardiac sources of stroke and discusses the role of echocardiography in clinical practice.
对潜在栓子来源进行调查是治疗缺血性卒中和短暂性脑缺血发作患者的重要诊断步骤。据估计,心源性栓塞是所有缺血性卒中病例中15%至30%的致病因素。心源性栓塞性卒中通常较为严重,复发率和死亡率较高。包括心房颤动、心室血栓、心脏瓣膜病、心脏肿瘤和心脏结构缺陷在内的各种心脏疾病都可导致心源性栓塞性卒中。虽然主动脉弓不是心脏结构,但通常被视为心脏栓塞来源(心主动脉来源),本文将对此进行综述。超声心动图(经胸和经食管)是一种广泛应用且用途广泛的技术,可提供卒中患者血栓栓塞风险的全面信息。本文综述了潜在的心脏性卒中来源,并讨论了超声心动图在临床实践中的作用。