quarta-feira, julho 07, 2010

Embolização e o Ecocardiograma

Recommendations for echocardiography use in the diagnosis and management of cardiac sources of embolism
Table 1
Potential cardioembolic sources

Major risk sources
Atrial fibrillation
Recent myocardial infarction
Previous myocardial infarction (LV aneurysm)
Cardiac masses
 Intracardiac thrombus Atrial septal aneurysm
 Intracardiac tumours
 Fibroelastoma Patent foramen ovale
 Marantic vegetations
Rheumatic valve disease (mitral stenosis)
Aortic arch atheromatous plaques
Mechanical valve prosthesis
Table 3
Echocardiographic predictors of embolic risk in patients with atrial fibrillation

Echocardiographic risk factors
Left ventricular systolic dysfunction (EF < 35%)
Complex aortic plaquesa
LAA thrombi or spontaneous echo contrasta
LAA dysfunction (emptying blood flow velocities ≤20 cm/s and/or reduced contraction at M-mode)

A potential cardiac source of embolism should be considered in all patients presenting with stroke or TIA. In this regard, echocardiography is not only a powerful tool for the evaluation of cardioembolic sources of stroke, but also to establish recommendations for the primary and secondary prevention of cardioembolic stroke.

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