Subvalvular calcification of mitral valve.

1,454

297

Abstract-The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on the prevention of ischemic stroke among survivors of ischemic stroke or transient ischemic attack. Evidence-based recommendations are included for the control of risk factors, interventional approaches for atherosclerotic disease, antithrombotic treatments for cardioembolism, and the use of antiplatelet agents for noncardioembolic stroke. Further recommendations are provided for the prevention of recurrent stroke in a variety of other specific circumstances, including arterial dissections; patent foramen ovale; hyperhomocysteinemia; hypercoagulable states; sickle cell disease; cerebral venous sinus thrombosis; stroke among women, particularly with regard to pregnancy and the use of postmenopausal hormones; the use of anticoagulation after cerebral hemorrhage; and special approaches for the implementation of guidelines and their use in high-risk populations. (Stroke. 2006;37:577-617.)

Section: Mitral Annular Calcificationmentioning

confidence: 99%

Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack

Sacco¹,

Adams²,

Albers³

et al. 2006

1,454

297

“…Atrial myxoma," fat emboli, 20 septic material, 81 -" tumor," venous clots with a right-to-left cardiac shunt, 2426 congenital heart disease, cardiomyopathy, 27 non-bacterial thrombotic endocarditis, 28 ' 81 mitral annulus calcification 32 ' M and prolapsing mitral valves 3 ' 4 make up a small group. Idiopathic AF as an etiology for arterial embolization will be discussed with atherosclerotic AF.…”

Section: Source Of Cerebral Embolimentioning

confidence: 99%

Management of cerebral embolism of cardiac origin.

Easton¹,

Sherman²

1980

148

SUMMARY Tbe cardiac conditions most commonly associated with cerebral embolism are rheumatic heart disease (RHD), atherosclerotic heart disease (myocardlal infarction and atrial arrhythmias) and other kinds of nonvalvular atrial fibrillation (AF). Tbe natural history of cerebral embolism from these cardiac sources is reviewed. Virtually all rheumatic hearts producing emboll hare mitral stenosis, but not all of them are in AF. Of patients with RHD, 10-20% will experience a systemic embolus, and approximately half will hare a recurrence, usually early. Of patients with a myocardial infarction, 5-12% will have a clinically apparent systemic embolus, and one-third to one-half have a recurrence, usually early. As many as 10-20% of patients with nonrheumatic AF have a systemic embolus. Anticoagulation reduces systemic embolism to 10-20% of the natural incidence in RHD, and it reduces embollc recurrences to 10-20% of tbe natural recurrence rate. Anticoagulation diminishes tbe incidence of emboll In myocardial Infarction to 25% of the natural Incidence. It is not known what effect anticoagulation has on the incidence of embolism hi nonrbeumatic AF. Tbe data regarding the effect of valvulotomy and prosthetic valve placement in RHD are briefly reviewed. Recommendations are made for tbe use and timing of anticoagulation based on the available data.

“…Although the incidence of systemic and cerebral embolism is not clear, 279 -284 thrombus has been found at autopsy on heavily calcified annular tissue, and echogenic densities have been identified in the LV outflow tract in patients with MAC who experience cerebral ischemic events. 280,282 Aside from the risk of thromboembolism, spicules of fibrocalcific material may embolize from the calcified mitral annulus. 279,281,283 The relative frequencies of calcific and thrombotic embolism are unknown.…”

Section: Mitral Annular Calcificationmentioning

confidence: 99%

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

Furie¹,

Kasner²,

Adams³

et al. 2011

1,424

591

Abstract-The aim of this updated statement is to provide comprehensive and timely evidence-based recommendations on the prevention of ischemic stroke among survivors of ischemic stroke or transient ischemic attack. Evidence-based recommendations are included for the control of risk factors, interventional approaches for atherosclerotic disease, antithrombotic treatments for cardioembolism, and the use of antiplatelet agents for noncardioembolic stroke. Further recommendations are provided for the prevention of recurrent stroke in a variety of other specific circumstances, including arterial dissections; patent foramen ovale; hyperhomocysteinemia; hypercoagulable states; sickle cell disease; cerebral venous sinus thrombosis; stroke among women, particularly with regard to pregnancy and the use of postmenopausal hormones; the use of anticoagulation after cerebral hemorrhage; and special approaches to the implementation of guidelines and their use in high-risk populations. (Stroke. 2011;42:227-276.)