Learning objectives
To describe CT and MRI cardiac imaging findings that might be cause of stroke.
To identify subtle cardiac findings in angiographic-CT study usually performed in initial diagnosis of stroke.
To perform a proper differential diagnosis in order to establish an optimal therapeutic approach in the acute stroke setting and further preventive therapy.
Background
Stroke is a leading cause of death and disability in developed countries.
Worldwide,
brain infarction is the second most common cause of mortality and the third most common cause of disability.
While the overall rate of stroke-related mortality is decreasing,
the absolute number of people with stroke and the global burden of stroke-related disability is high and increasing.
Cardiogenic strokes account for approximately 25% of all ischemic strokes,
with an increasing risk in elderly population.
Overall,
it has a similar frequency throughout the world if...
Findings and procedure details
TABLE OF CONTENTS
Overview
Atrium (> left)
High risk causes: atrial fibrillation,
atrial thrombi,
atrial tumors.
Low risk causes: patent foramen ovale,
interatrial septal aneurysm,
interatrial communication
Ventricle (> left)
High risk causes: ventricular thrombi and myocardial infarction,
ventricular tumors,
dilated cardiomyopathy.
Low risk causes: myocardial contractility dysfunction,
hypertrophic cardiomyopathy,
interventricular communication.
Valvular heart disease
High risk causes: endocarditis,
prosthetic valves,
mitral stenosis,
papillary fibroelastoma.
Low risk causes: annular calcification and prolapse.
Rare causes
Left ventricular noncompaction cardiomyopathy
Myocarditis
Iatrogenic disease
Vascular disease
OVERVIEW
In...
Conclusion
Radiologists play a pivotal role in stroke diagnosis and management.
Further neuroimaging,
new cardiac imaging techniques as CT and MRI can be used to identify several subtle cardiac pathologies responsible for stroke that otherwise may remain unnoticed.
Radiologists should be able to recognize these findings in order to perform an accurate diagnosis,
which is in great value for patient´s management.
Personal information
Contact details:
Dr.
Flavio Zuccarino
Thoracic Radiology Section.
Department of Radiology,
Hospital del Mar.
Passeig Marítim,
25-29,
08003 Barcelona,
Spain.
Email:
[email protected]
Dr.
Marta Vilas
Resident in training.Department of Radiology,
Hospital del Mar.
Passeig Marítim,
25-29,
08003 Barcelona,
Spain.
Email:
[email protected]
Department of Radiology,
Hospital del Mar:
Thoracic radiology section:
Dr.
M.
Cufí
Dr.
L.
A.
Del Carpio Bellido
Dr.
F.
Fernández Alarza
Dr.
A.
Gayete Cara
Dr.
E.
Ripoll
Dr.
F.
Zuccarino
Neuroradiology section:
Dr.
S.
Medrano
Resident in training:
Dr.
M.
Vilas
Cardiology Department,...
References
1. Ajlan AM,
Bagdadi RR,
Alama MN,
Ayoub O.
Impact of Implementing Cardiac CT in Evaluating Patients Suspected of Cardioembolic Stroke.
J Comput Assist Tomogr.
2016 May-Jun;40(3):380-6.
2. Arboix A,
Alió J.
Cardioembolic Stroke: Clinical Features,
Specific Cardiac Disorders and Prognosis.
Curr Cardiol Rev.
2010;6:150–61.
3. Arsava EM,
Ballabio E,
Benner T,
et al.
The Causative Classification of Stroke system: an international reliability and optimization study.
Neurology 2010; 75:1277.
4.Baxi AJ,
Restrepo CS,
Vargas D,
Marmol-Velez A,
Ocazionez D,
Murillo H.
Hypertrophic Cardiomyopathy from A...