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Stroke secondary to cardiogenic embolism

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Stroke secondary to atrial fibrillation; Cardioembolic stroke

Symptoms:

Symptoms of stroke occur suddenly and include:

• Numbness or weakness of the face, arm, or leg (especially on one side of the body)
• Tingling or other abnormal sensations
• Confusion, trouble speaking, or understanding speech
• Problems seeing out of one or both eyes
• Dizziness
• Loss of coordination and balance, which can cause trouble walking
• Severe headache

Other symptoms may include:

• Vertigo (abnormal sensation of movement)
• Swallowing difficulties
• Personality changes
• Mood and emotion changes
• Urinary incontinence (lack of control over bladder)
• Lack of control over the bowels
• Sleepiness, stuporous , lethary
• Loss of consciousness
• Coma

Signs and tests:

A physical exam may reveal the following:

• Changes in vision or visual fields
• Clots in the retina of the eye
• Changes in reflexes including abnormal reflexes or abnormal extent of "normal" reflexes
• Abnormal eye movements
• Muscle weakness
• Decreased sensation

The pulse may be irregular. Abnormal sounds may be heard when listening to the heart with a stethoscope. There may be signs of splinter hemorrhages .

Tests include:

• Head CT scan
• MRI of head , MRA of the head
• ECG showing arrhythmia , such as atrial fibrillation
• Echocardiogram
• Transcranial Doppler (ultrasound of the head)

References:

Mosca L, Banka CL, Benjamin EJ, et al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update. Circulation . 2007; Published online before print February 19, 2007.

Thom T, Haase N, Rosamond W, et al. Heart disease and stroke statistics--2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation . 2006 Feb 14;113(6):e85-151. Epub 2006 Jan 11.

Ferro JM. Cardioembolic stroke: an update. Lancet Neurol . 2003 Mar;2(3):177-88.

• Review Date: 2/20/2007
• Reviewed By: Updated by: A.D.A.M. Editorial Team: Greg Juhn, M.T.P.W., David R. Eltz, Kelli A. Stacy. Previously reviewed by Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network. (August 2006)

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