In the study, of the 93 patients who had an MRI and echocardiogram of their heart after a stroke, MRI detected nearly twice as many potential causes of stroke originating from the heart compared to echocardiography. MRI also detected significant heart conditions that predispose a patient to stroke in 30 percent of patients compared to echocardiography. These additional findings included acute myocardial infarction, myocardial scarring, and left ventricular aneurysms. Echocardiography was, however, more sensitve to detecting potential embolic lesions on prosthetic cardiac valves and strokes related to a hole in the heart. (Abstract 132 can be found at www.SIRmeeting.org.)

"By using cardiac MRI and echocardiography to assess stroke patients, we have two sets of eyes: two ways to see what is causing the stroke to provide the best immediate care, and two ways to see what problems lie ahead for this patient that we could prevent with better long-term care," Sheehan added. "The earlier we can detect underlying cardiac problems, the more quickly we can intervene to prevent future strokes. One stroke is more than enough. The chances of experiencing another stroke can be dramatically reduced by taking appropriate actions."


Definition of "Stroke" and "Cardioembolic Stroke"

A stroke occurs when the blood supply to a part of the brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Within a few minutes, brain cells begin to die; as a result, abilities controlled by that area of the brain are lost. These abilities can include speech, movement, vision and memory.

There are two basic types of stroke: ischemic (blockage of an artery) or hemorrhagic (rupture of an artery). About 80 percent of strokes are ischemic strokes. They occur when blood clots, plaque or vegetation block arteries to the brain and result in damage. Ischemic strokes are either embolic or thrombotic.

Typically in an embolic stroke, a blood clot forms somewhere in the body, usually the heart, and travels through the blood stream to the brain. Once in the brain, the clot will continue traveling until it lodges in a small blood vessel blocking blood flow beyond that point, resulting in a stroke. This type of blood clot is called an embolus.

A cardioembolic stroke occurs when the embolus has traveled from the heart. About 1 in 4 ischemic strokes are cardioembolic. The annual incidence of cardioembolic strokes in the U.S. is estimated at approximately 125,000 cases. These strokes can not be considered a single disease process as there are many different types of cardiac disorders that lead to cardioembolic stroke, each with unique clinical features, risks of initial and recurrent stroke, and optimal therapy.

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