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Dtsch Med Wochenschr 2021; 146(12): 801-808
DOI: 10.1055/a-1221-7095
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Rationale kardiale Diagnostik nach ischämischem Schlaganfall oder TIA

Cardiac diagnostics after ischemic stroke or transitory ischemic attack
Renate B. Schnabel
,
Karl Georg Häusler
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Eine strukturierte kardiologische Abklärung nach ischämischem Schlaganfall umfasst eine gezielte Anamnese, eine körperliche Untersuchung, ein 12-Kanal-EKG, ein Rhythmus-Monitoring für kumulativ 72 h, regelhaft eine transthorakale Echokardiografie und bei Verdacht auf eine atriale Emboliequelle eine transösophageale Echokardiografie. Eine erweiterte kardiale Abklärung (z. B. mittels MRT/CT, verlängertes Rhythmus-Monitoring) sollte Befund- und Patienten-bezogen erfolgen.

Abstract

Stroke is the most common cause of permanent disability and one of the most common causes of death. Cardio-embolic strokes are associated with a poor prognosis and a high risk of recurrence compared to other stroke etiologies. The most common source of cardiac embolism is atrial fibrillation which must be quickly identified to optimize secondary stroke prevention. A structured evaluation after ischemic stroke includes taking the medical history, a physical examination, 12-lead ECG recording, rhythm monitoring for 72 h, transthoracic echocardiography and transesophageal echocardiography, if an atrial embolic source of stroke is suspected. Extended cardiac work-up (e. g., MRI/CT, prolonged rhythm monitoring) should be performed in selected patients based on diagnostic findings.

Schlüsselwörter

ischämischer Schlaganfall - kardioembolische Genese - TIA - Sekundärprävention

Key words

ischemic stroke - cardio-embolic stroke - TIA - secondary stroke prevention


Publication History

Article published online:
15 June 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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