Destiny of a cardiac embolus !

One of my patients with atrial fibrillation  recently developed a  fairly  moderate  sized right MCA stroke that resulted in dense left sided hemiplegia .He was on warfarin , but the stroke was confirmed to be ischemic,the etiology was fixed as cardio embolic .After a  smart  recovery he asked this question. Why did the clot  from  my  heart preferred  to enter the  brain doctor ?  Is there no other place for it  to go ? I  told him in simple terms , “It is  your destiny and  the clot’s wish”.  In fact , you are some what blessed as the clot did not enter  the left side of the brain .If it had gone, your speech would have severely affected and you may  not be asking this question to me ! It is true the clot do have other options to  embolise ,  however they are still  trouble some ! What is the diameter of internal carotid artery , and cerebral artery ? The common size of LA appendage clot almost match with this ! It can go straight down to your leg , kidney , intestines or upper limbs .All are equally dangerous  and present dramatically . Very rarely  it can enter  coronary  arteries  bringing a heart attack rather than a brain attack .If it is going to the legs you are at risk of acute monoplegia instead of chronic hemiplegia .Peripheral embolism are very painful .Intestinal ischemia evokes a most excruciating pain one can  ever encounter !  Luckily  stroke is not painful.God is kind enough ,he foresaw  cerebral ischemia to b...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Atrial fibrillation cardiac source of embolism stroke aortic arch type and embolic risk cardiac emboli carotid artery origin angle and risk of stroke clot deflection in stroke embolic stroke fate of clot from heart Ischemic stroke Source Type: blogs