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Cardiac MRI improves identification of etiology of ischemic stroke

Journal of Cardiovascular Magnetic Resonance
Springer (Biomed Central Ltd.)
Publication Date
DOI: 10.1186/1532-429x-14-s1-p79
  • Poster Presentation
  • Medicine


Cardiac MRI improves identification of etiology of ischemic stroke POSTER PRESENTATION Open Access Cardiac MRI improves identification of etiology of ischemic stroke Alex Baher1*, Ashkan Mowla2, John J Volpi2, Dipan J Shah3 From 15th Annual SCMR Scientific Sessions Orlando, FL, USA. 2-5 February 2012 Background Stroke is the third leading cause of death in the United States. Ischemic etiologies account for the vast majority of all cases of stroke from which about 20-25% have a cardiogenic cause. Transthoracic echocardiography (TTE) is widely used as the initial test for evaluating patients with a suspected cardioembolic of stroke while additional studies are often required to further detect a cardiac source in patients with unremarkable TTE. While transesophageal echocardiography (TEE) has pro- vided clinicians with invaluable information in these cases, most physicians find it cumbersome at best and patients it extremely uncomfortable. CMR is a novel imaging modality that is increasingly being used in assessing patients with cardiovascular disease. The non- invasive nature of this test makes it an attractive option for evaluating strokes for which a TTE is non-diagnos- tic. In this study, we assessed the feasibility of using CMR as an imaging modality additional to TTE for detection of cardioembolic strokes. Methods CMR was performed on 54 patients (25 men), age of 64.5± 16.3 years, who presented between August 2009 and June 2011 to our hospital with an acute stroke detected by diffusion weighted imaging brain MRI. In addition to the CMR all patients received a “routine” stroke workup which included a TTE, MRA of head and neck, carotid duplex, and laboratory workup. Patients without an obvious stroke etiology underwent additional studies such as transcranial duplex with or without a bubble study, and/or a cerebral angiogram. We divided patients based on the TOAST criteria for classification of ischemic stroke into atherothrombotic, cardioembolic, lacunar, other causes, and cry

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