Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review
Cardioembolic strokes account for 20–25% of all ischaemic strokes, with their incidence increasing with age. Cardiac imaging plays a crucial role in identifying cardioembolic causes of stroke, with early and accurate identification affecting treatment, preventing recurrence, and reducing stroke inci...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/11/1/13 |
| _version_ | 1797343339728601088 |
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| author | Elizabeth Hui En Thong William K. F. Kong Kian-Keong Poh Raymond Wong Ping Chai Ching-Hui Sia |
| author_facet | Elizabeth Hui En Thong William K. F. Kong Kian-Keong Poh Raymond Wong Ping Chai Ching-Hui Sia |
| author_sort | Elizabeth Hui En Thong |
| collection | DOAJ |
| description | Cardioembolic strokes account for 20–25% of all ischaemic strokes, with their incidence increasing with age. Cardiac imaging plays a crucial role in identifying cardioembolic causes of stroke, with early and accurate identification affecting treatment, preventing recurrence, and reducing stroke incidence. Echocardiography serves as the mainstay of cardiac evaluation. Transthoracic echocardiography (TTE) is the first line in the basic evaluation of structural heart disorders, valvular disease, vegetations, and intraventricular thrombus. It can be used to measure chamber size and systolic/diastolic function. Trans-oesophageal echocardiography (TOE) yields better results in identifying potential cardioembolic sources of stroke and should be strongly considered, especially if TTE does not yield adequate results. Cardiac computed tomography and cardiac magnetic resonance imaging provide better soft tissue characterisation, high-grade anatomical information, spatial and temporal visualisation, and image reconstruction in multiple planes, especially with contrast. These techniques are useful in cases of inconclusive echocardiograms and can be used to detect and characterise valvular lesions, thrombi, fibrosis, cardiomyopathies, and aortic plaques. Nuclear imaging is not routinely used, but it can be used to assess left-ventricular perfusion, function, and dimensions and may be useful in cases of infective endocarditis. Its use should be considered on a case-by-case basis. The accuracy of each imaging modality depends on the likely source of cardioembolism, and the choice of imaging approach should be tailored to individual patients. |
| first_indexed | 2024-03-08T10:46:11Z |
| format | Article |
| id | doaj.art-556cf74b9d214c7aa9e44969c79d42d8 |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-08T10:46:11Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-556cf74b9d214c7aa9e44969c79d42d82024-01-26T17:04:54ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252023-12-011111310.3390/jcdd11010013Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A ReviewElizabeth Hui En Thong0William K. F. Kong1Kian-Keong Poh2Raymond Wong3Ping Chai4Ching-Hui Sia5Department of Medicine, National University Health System, Singapore 119228, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore 119074, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore 119074, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore 119074, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore 119074, SingaporeDepartment of Cardiology, National University Heart Centre Singapore, Singapore 119074, SingaporeCardioembolic strokes account for 20–25% of all ischaemic strokes, with their incidence increasing with age. Cardiac imaging plays a crucial role in identifying cardioembolic causes of stroke, with early and accurate identification affecting treatment, preventing recurrence, and reducing stroke incidence. Echocardiography serves as the mainstay of cardiac evaluation. Transthoracic echocardiography (TTE) is the first line in the basic evaluation of structural heart disorders, valvular disease, vegetations, and intraventricular thrombus. It can be used to measure chamber size and systolic/diastolic function. Trans-oesophageal echocardiography (TOE) yields better results in identifying potential cardioembolic sources of stroke and should be strongly considered, especially if TTE does not yield adequate results. Cardiac computed tomography and cardiac magnetic resonance imaging provide better soft tissue characterisation, high-grade anatomical information, spatial and temporal visualisation, and image reconstruction in multiple planes, especially with contrast. These techniques are useful in cases of inconclusive echocardiograms and can be used to detect and characterise valvular lesions, thrombi, fibrosis, cardiomyopathies, and aortic plaques. Nuclear imaging is not routinely used, but it can be used to assess left-ventricular perfusion, function, and dimensions and may be useful in cases of infective endocarditis. Its use should be considered on a case-by-case basis. The accuracy of each imaging modality depends on the likely source of cardioembolism, and the choice of imaging approach should be tailored to individual patients.https://www.mdpi.com/2308-3425/11/1/13cardioembolicstrokeimagingechocardiogramnuclear imagingcomputed tomography |
| spellingShingle | Elizabeth Hui En Thong William K. F. Kong Kian-Keong Poh Raymond Wong Ping Chai Ching-Hui Sia Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review Journal of Cardiovascular Development and Disease cardioembolic stroke imaging echocardiogram nuclear imaging computed tomography |
| title | Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review |
| title_full | Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review |
| title_fullStr | Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review |
| title_full_unstemmed | Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review |
| title_short | Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review |
| title_sort | multimodal cardiac imaging in the assessment of patients who have suffered a cardioembolic stroke a review |
| topic | cardioembolic stroke imaging echocardiogram nuclear imaging computed tomography |
| url | https://www.mdpi.com/2308-3425/11/1/13 |
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