Cardioembolic stroke in patients with atrial fibrillation
DOI:
https://doi.org/10.18203/2320-6012.ijrms20222285Keywords:
Cardioembolic stroke, AF, Stroke ischemicAbstract
Stroke is a neurological emergency in the form of disturbances in brain function that occur suddenly, it can be focal or global, which lasts for 24 hours or more and even causes death, with no other obvious cause other than vascular disorders. Strokes are generally divided into two main categories: ischemic stroke and hemorrhagic stroke. Atrial fibrillation (AF) is a cardiac arrhythmia and is often associated with stroke, dementia, and death. In our case, an 81-year-old woman came to the ED complaining of sudden loss of consciousness with GCS E2V1M5. A non-contrast CT scan of the head revealed cerebral atrophy and senile cerebellum accompanied by suspicion of infarction in the left globus pallidus. The ECG results showed an irregular rhythm (irregular P-P) leading to AF. AF is a high-risk factor for stroke because of impaired blood pumping, so the risk of clots forming which can then escape and flow to the brain causes blockage of blood flow to the brain and stroke occurs. It is therefore important for routine treatment and control of high-risk patients with heart rhythm disorders such as AF to prevent embolic strokes.
References
Mahendra IBN. Krisis Hipertensi (Emergensi dan Urgensi) Edisi I. Badung. 2020.
Donkor ES. Stroke in the 21st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life. Stroke Res Treat. 2018;2018:3238165.
Lina R, Sacuiu S, Wetterberg H, Najar J, Guo X, Kern S, Zettergren A et al. Atrial Fibrillation, Stroke, and Silent Cerebrovascular Disease. Neurology. 2021;97(16):e1608-19.
Adria A, Alio J. Acute Cardioembolic Cerebral Infarction: Answers to Clinical Questions. Curr Cardiol Rev. 2012;8(1):54-67.
AHA (American Heart Association). Cardiovascular Disease: Cardioembolic Stroke. The American Heart Association Office of Federal Advocacy: Washington DC; 2017.
RISKESDAS. Badan Penelitian Dan Pengembangan Kesehatan Kementerian Kesehatan RI. Jakarta. 2018.
Sandhu RK, Healey JS. Atrial Fibrillation and Stroke: Chicken or Egg? Does It Really Matter? Europace: Europ Pacing, Arrhythmias Cardiac Electrophysiol. 2022;22(4).
Ischemic Stroke Incidence Worldwide by Gender 2019. Statista. Available at: https://www.statista.com/statistics/1117505/worldwide-ischemic-stroke-incidence/. Accessed on 10 June 2022.
Pistoia F, Sacco S, Tiseo C, Degan D, Ornello R, Carolei A. The Epidemiology of Atrial Fibrillation and Stroke. Cardiol Clin. 2016;34(2).
Essa H, Hill AM, Lip GYH. Atrial Fibrillation and Stroke. Cardiac Electrophysiol Clin. 2021;13(1).
Vanassche T, Lauw MN, Eikelboom JW, Healey JS, Hart RG, Alings M, Avezum A et al. Risk of Ischaemic Stroke according to Pattern of Atrial Fibrillation: Analysis of 6563 Aspirin-Treated Patients in ACTIVE-A and AVERROES. European Heart J. 2015;36(5).
Ibrahim M, Russman A, Buletko AB. Atrial Fibrillation and Ischemic Stroke: A Clinical Review. Seminars Neurol. 2021;41(04):348-64.
Pistoia F, Sacco S, Tiseo C, Degan D, Ornello R, Carolei A. The Epidemiology of Atrial Fibrillation and Stroke. Cardiol Clin. 2016;34(2).
Tarek A, Mehdirad AA, Levine E. CHADS2 Score for Stroke Risk Assessment in Atrial Fibrillation. 2020. Available at: https://emedicine.medscape.comoverview. Accessed May 13, 2022.
AHA. Cardioembolic Stroke, 2017. Available at: https://doi.org/10.1161/CIRCRESAHA.116.308407. Accessed on 13 May 2022.
Brian GF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of Clinical Classification Schemes for Predicting Stroke: Results From the National Registry of Atrial Fibrillation. JAMA. 2001;285(22):2864-70.
ESC Guidelines on Atrial Fibrillation (Management Of). Available at: https://www.escardio.org/Guidelines/ClinicalPractice-Guidelines/Atrialillation-Management. Accessed on 13 May 2022.