Evaluation of causal heart diseases in cardioembolic stroke by cardiac computed tomography

Abstract

Cardioembolic stroke is a potentially devastating condition and tends to have a poor prognosis compared with other ischemic stroke subtypes. Therefore, it is important for proper therapeutic management to identify a cardiac source of embolism in stroke patients. Cardiac computed tomography (CCT) can detect the detailed visualization of various cardiac pathologies in the cardiac chambers, interatrial and interventricular septum, valves, and myocardium with few motion artifacts and few dead angles. Multiphase reconstruction images of the entire cardiac cycle make it possible to demonstrate cardiac structures in a dynamic manner. Consequently, CCT has the ability to provide high-quality information about causal heart disease in cardioembolic stroke. In addition, CCT can simultaneously evaluate obstructive coronary artery disease, which may be helpful in surgical planning in patients who need urgent surgery, such as cardiac tumors or infective endocarditis. This review will introduce the potential clinical applications of CCT in an ischemic stroke population, with a focus on diagnosing cardioembolic sources using CCT.

Keywords: Acute ischemic stroke; Cardioembolic stroke; Cardiac computed tomography

Core Tip: Cardiac computed tomography (CCT) can detect the detailed visualization of causal heart disease in cardioembolic stroke. This review introduces the potential clinical applications of CCT in an ischemic stroke population, with a focus on diagnosing cardioembolic sources using CCT. Specifically, left atrial thrombus and associated pathologies, left ventricular thrombus and associated pathologies, intracardiac tumors, valvular abnormalities, and causal pathologies of paradoxical embolism are discussed.