Embolic strokes of undetermined source: a clinical consensus statement of the ESC Council on Stroke, the European Association of Cardiovascular Imaging and the European Heart Rhythm Association of the ESC
Eur Heart J. 2024 Apr 30:ehae150. doi: 10.1093/eurheartj/ehae150. Online ahead of print.ABSTRACTOne in six ischaemic stroke patients has an embolic stroke of undetermined source (ESUS), defined as a stroke with unclear aetiology despite recommended diagnostic evaluation. The overall cardiovascular risk of ESUS is high and it is important to optimize strategies to prevent recurrent stroke and other cardiovascular events. The aim of clinicians when confronted with a patient not only with ESUS but also with any other medical condition of unclear aetiology is to identify the actual cause amongst a list of potential differential diagnoses, in order to optimize secondary prevention. However, specifically in ESUS, this may be challenging as multiple potential thromboembolic sources frequently coexist. Also, it can be delusively reassuring because despite the implementation of specific treatments for the individual pathology presumed to be the actual thromboembolic source, patients can still be vulnerable to stroke and other cardiovascular events caused by other pathologies already identified during the index diagnostic evaluation but whose thromboembolic potential was underestimated. Therefore, rather than trying to presume which particular mechanism is the actual embolic source in an ESUS patient, it is important to assess the overall thromboembolic risk of the patient through synthesis of the individual risks linked to all pathologies present, regardless if presumed causally assoc...
Source: Atherosclerosis - Category: Cardiology Authors: George Ntaios Helmut Baumgartner Wolfram Doehner Erwan Donal Thor Edvardsen Jeff S Healey Bernard Iung Hooman Kamel Scott E Kasner Eleni Korompoki Babak B Navi Christian Pristipino Luca Saba Renate B Schnabel Emma Svennberg Gregory Y H Lip Source Type: research
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