eMedicine Specialties > Neurology > Neuro-vascular Diseases

Cardioembolic Stroke: Follow-up

Author: Michael J Schneck, MD, Associate Professor, Departments of Neurology and Neurosurgery, Stritch School of Medicine, Loyola University; Associate Director, Stroke Program, Director, Neurology Intensive Care Program, Medical Director, Neurosciences ICU, Loyola University Medical Center
Coauthor(s): Lei Xu, MD, PhD, Resident Physician, Department of Neurology, Loyola University Chicago, Stritch School of Medicine; Santiago Palacio, MD, Neurology Fellow, Department of Medicine (Division of Neurology)
Contributor Information and Disclosures

Updated: Feb 13, 2008

Follow-up

Patient Education

For excellent patient education resources, visit eMedicine's Stroke Center. Also, see eMedicine's patient education article Stroke.

Miscellaneous

Medicolegal Pitfalls

  • Recently, the underuse of warfarin in patients with atrial fibrillation has been a high-profile issue and the source of many lawsuits. Health Care Financing Administration quality control monitoring now includes the use of warfarin at the time of discharge in patients with atrial fibrillation.
  • When atrial fibrillation is identified, anticoagulation should be carefully considered, and if not prescribed (and perhaps half or more of outpatients with atrial fibrillation do not benefit sufficiently to warrant it), the reason should be recorded in the medical record (eg, estimated low risk for stroke based on CHADS2, warfarin too risky because of high bleeding risk, no access to reliable anticoagulation monitoring, patient declined after explanation of risks and benefits) in case of subsequent stroke. As discussed above, the CHADS2 (2001) scheme for estimation of risk stratification is the best validated.
  • It is the authors' view that risk stratification to estimate stroke risk should be an integral part of the decision to begin anticoagulation treatment in these patients.
 


More on Cardioembolic Stroke

Overview: Cardioembolic Stroke
Differential Diagnoses & Workup: Cardioembolic Stroke
Treatment & Medication: Cardioembolic Stroke
Follow-up: Cardioembolic Stroke
Multimedia: Cardioembolic Stroke
References
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References

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Further Reading

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Keywords

cardiogenic embolism, cardiac embolism, cardioembolic stroke, atrial fibrillation, atrial flutter, heart attack, transient ischemic attack, TIA, coronary artery disease, CAD, congestive heart failure, CHF, myocardial infarction, MI

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Contributor Information and Disclosures

Author

Michael J Schneck, MD, Associate Professor, Departments of Neurology and Neurosurgery, Stritch School of Medicine, Loyola University; Associate Director, Stroke Program, Director, Neurology Intensive Care Program, Medical Director, Neurosciences ICU, Loyola University Medical Center
Michael J Schneck, MD is a member of the following medical societies: American Academy of Neurology, American Society of Neuroimaging, Neurocritical Care Society, and Stroke Council of the American Heart Association
Disclosure: boehringer-ingelheim Honoraria Speaking and teaching; sanofi/bms Honoraria Speaking and teaching; pfizer Honoraria Speaking and teaching; genentech Honoraria Speaking and teaching; ucb pharma Honoraria Speaking and teaching; talecris Consulting fee Other; nmt medical  Independent contractor; NIH Grant/research funds Independent contractor; vernalis Grant/research funds Independent contractor; sanofi Grant/research funds Independent contractor

Coauthor(s)

Lei Xu, MD, PhD, Resident Physician, Department of Neurology, Loyola University Chicago, Stritch School of Medicine
Lei Xu, MD, PhD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Santiago Palacio, MD, Neurology Fellow, Department of Medicine (Division of Neurology)
Santiago Palacio, MD is a member of the following medical societies: American Heart Association
Disclosure: Nothing to disclose.

Medical Editor

Edward L Hogan, MD, Professor, Department of Neurology, Medical College of Georgia; Emeritus Professor and Chair, Department of Neurology, Medical University of South Carolina
Edward L Hogan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, American Neurological Association, American Society for Biochemistry and Molecular Biology, Phi Beta Kappa, Sigma Xi, Society for Neuroscience, and Southern Clinical Neurological Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Howard S Kirshner, MD, Professor of Neurology, Psychiatry and Hearing and Speech Sciences, Vice Chairman, Department of Neurology, Vanderbilt University School of Medicine; Director, Vanderbilt Stroke Center; Program Director, Stroke Service, Vanderbilt Stallworth Rehabilitation Hospital; Consulting Staff, Department of Neurology, Nashville Veterans Affairs Medical Center
Howard S Kirshner, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, American Heart Association, American Medical Association, American Neurological Association, American Society of Neurorehabilitation, National Stroke Association, Phi Beta Kappa, and Tennessee Medical Association
Disclosure: Boehringer Ingelheim Honoraria Speaking and teaching; BMS/Sanofi Honoraria Speaking and teaching; Novartis Honoraria Speaking and teaching

Chief Editor

Helmi L Lutsep, MD, Professor, Department of Neurology, Oregon Health & Science University; Associate Director, Oregon Stroke Center
Helmi L Lutsep, MD is a member of the following medical societies: American Academy of Neurology and American Stroke Association
Disclosure: Co-Axia Consulting fee Review panel membership; Talecris Consulting fee Review panel membership; AGA Medical Consulting fee Review panel membership; Boehringer Ingelheim Honoraria Speaking and teaching; Concentric Medical Consulting fee Review panel membership; Abbott Consulting fee Consulting; Sanofi  Consulting

 
 
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