Aortic Atherosclerosis: A Common Source of Cerebral Emboli, Often Overlooked!

We present a case of cerebral embolism arising from a mobile noncalcified complex aortic arch plaque diagnosed on a transesophageal echocardiogram and review the literature on its diagnosis, clinical implications, and management.
Source: American Journal of Therapeutics - Category: Drugs & Pharmacology Tags: Case Reports Source Type: research

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AbstractPurpose of ReviewAtrial fibrillation (AF) is the most common arrhythmia in adults. The number of patients with AF is anticipated to increase annually, mainly due to the aging population alongside improved arrhythmia detection. AF is associated with a significantly elevated risk of hospitalization, stroke, thromboembolism, heart failure, and all-cause mortality. Echocardiography is one of the key components of routine assessment and management of AF. Therefore, the aim of this review is to briefly summarize current knowledge on “novel” echocardiographic parameters that may be of value in the management o...
Source: Current Cardiovascular Imaging Reports - Category: Radiology Source Type: research
ConclusionAll collected data were observational, which precluded making strong recommendations. Furthermore, all CIs were wide, increasing the uncertainty of the observed effects. As such, evidence was insufficient to recommend rhythm or rate control as the first-line therapy for AF in older adults. As AF is particularly prevalent in older people, more randomized controlled trials are needed in this population.
Source: Drugs and Aging - Category: Geriatrics Source Type: research
Feasibility of Uninterrupted Direct Oral Anticoagulants with Temporary Switching to Dabigatran ("Dabigatran Bridge") for Catheter Ablation of Atrial Fibrillation. Int Heart J. 2019 Nov 15;: Authors: Aoyama D, Miyazaki S, Hasegawa K, Kaseno K, Ishikawa E, Mukai M, Miyahara K, Aiki T, Matsui A, Yamaguchi J, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Morishita T, Ishida K, Uzui H, Tada H Abstract Uninterrupted anticoagulation therapy during atrial fibrillation (AF) ablation minimizes the risk of periprocedural thromboembolic events. Although the use of direct oral anticoagulants (DOACs) has rapidly d...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
In conclusion, about one-third of the patients with AF did not regularly see a doctor in a medical institution and most of them had a CHADS2 score of more than one point in a Japanese rural area. Educating the public about the risks of AF is required. PMID: 31735770 [PubMed - as supplied by publisher]
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
The impact of atrial fibrillation (AF) catheter ablation vs. chronic antiarrhythmic therapy alone on clinical outcomes such as death and stroke remains unclear. We compared adverse outcomes for AF ablation versus chronic antiarrhythmic therapy in 1070 adults with AF treated between 2010 and 2014 in the Kaiser Permanente Northern California and Southern California healthcare delivery systems. Patients undergoing AF catheter ablation were matched to patients treated with only antiarrhythmic medications, based on age, gender, history of heart failure, history of coronary heart disease, history of hypertension, history of diab...
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
ConclusionsThe meta-analysis shows that the DOACs had greater effectiveness and safety compared to warfarin in real-world practice for stroke prevention, among Asian patients with NVAF.
Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research
With advances in congenital heart disease treatment, more patients with repaired or palliated defects are living longer [1]. Adult congenital heart disease (ACHD) is also associated with an increased risk of atrial fibrillation [2] and stroke, both haemorrhagic and embolic [3,4]. While there is an abundance of clinical trials evaluating novel oral anticoagulants, NOACs, in patients with acquired heart disease the opposite is true for ACHD. In the current issue, Pujol and co-workers [5] report their single centre experience of 215 ACHD patients treated with NOACs.
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
Angelika Batta, Bhupinder S Kalra, Raj KhirasariaNeurology India 2019 67(5):1200-1212 As the population is aging, clinicians are coming across more patients with atrial fibrillation and venous thromboembolism requiring anticoagulation to prevent stroke and systemic embolisms. Due to a high prevalence and unfavorable consequences, managing thromboembolic diseases have become areas of clinical concern. Traditional anticoagulants like heparin, low molecular weight heparin and warfarin have been used for the prevention and treatment of venous and arterial thromboses. But, issues of bleeding, parenteral route of administration...
Source: Neurology India - Category: Neurology Authors: Source Type: research
Publication date: Available online 15 November 2019Source: Neurología (English Edition)Author(s): Á. Lambea Gil, H. Tejada Meza, C.R. López Perales, J. Artal Roy, J. Marta Moreno
Source: Neurologia - Category: Neurology Source Type: research
Non –vitamin K antagonist oral anticoagulants (NOACs), such as dabigatran, are widely used to prevent ischemic stroke in patients with nonvalvular atrial fibrillation. Nonetheless, stroke occurs in 1–2% of patients, and the use of NOACs may increase the bleeding risk for patients who are receiving a cute treatment of intravenous thrombolysis (IVT) or endovascular thrombectomy (EVT). Idarucizumab, a monoclonal antibody developed to bind dabigatran, has been proven safe and effective for patients with uncontrolled bleeding or for patients planning to receive emergent procedures.
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Selected Topics: Neurological Emergencies Source Type: research
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