Calcific aortic valve and spontaneous embolic stroke: A review of literature

Khetarpal, Vipin; Mahajan, Nitin; Madhavan, Ramesh; Batra, Sachin; Mopala, Prashanth; Sagar, Amit; Rapolu, Praveen; Nangia, Sharad; Afonso, Luís

doi:10.1016/j.jns.2009.07.018

Cited by 26 publications

(30 citation statements)

References 47 publications

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“…The evidence for an association between native aortic valve disease and increased risk for stroke is from case reports and case series of patients with specific cardiac lesions such as such as Libman-Sacks endocarditis, 515 age-related calcification, 516 or bicuspid valves. 517 Pathological studies have demonstrated microthrombi on damaged aortic valves, which suggests a possible source for emboli, 518 but the clinical significance is uncertain.…”

Section: 511mentioning

confidence: 99%

Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

Kernan¹,

Ovbiagele²,

Black³

et al. 2014

Stroke

3,990

1,326

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The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors, intervention for vascular obstruction, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke. Recommendations are also provided for the prevention of recurrent stroke in a variety of specific circumstances, including aortic arch atherosclerosis, arterial dissection, patent foramen ovale, hyperhomocysteinemia, hypercoagulable states, antiphospholipid antibody syndrome, sickle cell disease, cerebral venous sinus thrombosis, and pregnancy. Special sections address use of antithrombotic and anticoagulation therapy after an intracranial hemorrhage and implementation of guidelines.

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Section: 511mentioning

confidence: 99%

Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

Kernan¹,

Ovbiagele²,

Black³

et al. 2014

Stroke

3,990

1,326

View full text Add to dashboard Cite

show abstract

“…Large emboli in patients with calcific aortic stenosis have been associated with cardiac catheterization and balloon valvuloplasty [35]. Regarding cardiac CT imaging in aortic stenosis, the measurement value for the aortic valve area is larger than the echocardiographic result [36] and valvular calcification adversely affects the accuracy of aortic valve area measurement [37].…”

Section: Calcific Aortic Stenosis and Mitral Valve Calcificationmentioning

confidence: 99%

Cardiac CT and MRI for Assessment of Cardioembolic Stroke

Choi

Kim

Kwon

et al. 2017

Cardiovasc Imaging Asia

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Cardioembolic stroke is generally severe with a high risk for both early and long-term recurrence, requiring early diagnosis. Cardiac CT and MRI are accurate noninvasive alternatives to echocardiography which can demonstrate the potential cardiac source of an embolism and exclude other potential sources. The major sources of cardioembolic stroke include atrial fibrillation, recent myocardial infarction, valvular heart disease, endocarditis, and atrial myxoma. Minor sources of cardioembolism are paradoxical embolism due to patent foramen ovale and atrial septal aneurysm, atrial or ventricular septal defects, calcific aortic stenosis, and mitral annular calcification. The appropriate clinical application of cardiac CT and MRI can allow an exact and timely diagnosis to be made in embolic stroke patients.

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“…ACC/AHA guidelines for the management of patients with valvular heart disease recommended aspirin (75–325 mg daily) for patients with mitral valve prolapse and prior cerebral TIA [31]. Warfarin is also recommended for stroke patients with mitral valve prolapse, and complicated with mitral regurgitation, atrial fibrillation, or left atrial thrombus. Aortic Valve Disease: Although autopsy studies have reported systemic embolism in about one‐third of cases with calcific aortic valves, there have been no randomized clinical trials on patients with stroke/TIA and aortic valve disease [32]. Cardiac Valve repair and prosthetic heart valves: There have been no random clinical trials to specifically address secondary stroke prevention in patients with cardiac valve repair or prosthetic heart valves.…”

Section: Medical Treatment For Patients With Cardiogenic Embolismmentioning

confidence: 99%

“…Aortic Valve Disease: Although autopsy studies have reported systemic embolism in about one‐third of cases with calcific aortic valves, there have been no randomized clinical trials on patients with stroke/TIA and aortic valve disease [32].…”

Section: Medical Treatment For Patients With Cardiogenic Embolismmentioning

confidence: 99%

“…Aortic Valve Disease: Although autopsy studies have reported systemic embolism in about one-third of cases with calcific aortic valves, there have been no randomized clinical trials on patients with stroke/TIA and aortic valve disease[32]. (4) Cardiac Valve repair and prosthetic heart valves: There have been no random clinical trials to specifically address secondary stroke prevention in patients with cardiac valve repair or prosthetic heart valves.…”

mentioning

confidence: 99%

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