| Author/Editor | Vene, Nina | |
| Title | Bolesti srca i moždani udar | |
| Translated title | Heart and stroke | |
| Type | članek | |
| Source | Medicus | |
| Vol. and No. | Letnik 10, št. 1 | |
| Publication year | 2001 | |
| Volume | str. 19-24 | |
| Language | cro | |
| Abstract | Cardiogenic embolism is responsible for one fifth of ischemic strokes. Anticoagulant therapy is the most appropriate treatment for the majority of patients with risk of cerebral embolism. The most common underlying etiology of cardioembolic stroke is the nonvalvular atrial fibrillation (AF Risk factors for stroke in these patients are advancing age, prior stroke or transient cerebral ischaemia, hypertension and impaired function of the left ventricle. Stratification of stroke risk identifies patients who benefit most and least from anticoagulation. Wanžarin (target INR 2.0-3.0) is recommended for high risk AF patients, for moderate risk either warfarin or acetil salicilic acid (ASA) (Andol, Andol 100 PLIVA) and for those with a low stroke risk ASA is indicated. For cardioversion of AF lasting more than 48 hours anticoagulation 3 weeks prior and 4 weeks post-cardioversion is indicated. Other sources of cardioembolism are mitral valve diseases, patent foramen ovale and atrial septal aneurysm, artificial mechanical heart valves and left ventricular thrombi after myocardial infarction (MI). Patients with rheumatic mitral valve disease and AF or prior embolism are at very high risk of thromboembolism and anticoagulant treatment is strongly recommended. On the other hand, mitral valve prolapse is associated with minimal risk of stroke and for asymptomatic patients antithrombotic therapy is not indicated. The incidence of paradoxic embolism associated with patent foramen ovale and atrial septa! aneurysm is unknown and anticoagulant treatment is indicated only in patients with strong evidence of paradoxic embolism, including evidence of venous fhrombosis. In patients with mechanical heart valves permanent anticoagulant treatment is indicated, intensity depends on the type and position of the valve. In patients with acute MI most thrombi form early after infarction, predominantly in patients with anterior MI. (Abstract truncated at 2000 characters) | |
| Descriptors | HEART DISEASES CEREBROVASCULAR DISORDERS ANTICOAGULANTS RISK FACTORS ATRIAL FIBRILLATION ELECTRIC COUNTERSHOCK ENDOCARDITIS HEART VALVE PROSTHESIS HEART SEPTAL DEFECTS, ATRIAL MYOCARDIAL INFARCTION |