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Infective endocarditis and stroke: pathophysiologic mechanisms and ultrasonographic evaluation

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Summary:Stroke, one of the most severe complications of infective endocarditis, is a leading cause of mortality and morbidity in developed countries. Cardioembolism is not the primary etiology but is responsible for 20% of ischemic strokes. A cerebral embolism occurs in more than 40% of cases of infective endocarditis, since the embolization of vegetations, that result from the infection of intracardiac structures, may lead to cerebral arteries occlusion and, therefore, cerebral infarction due to the absence of blood flow. The development of non-invasive techniques based on ultrasonography has widely potentiated the study of these diseases, both in cardiac and vascular areas, improving the understanding of their pathophysiological mechanisms. Echocardiography and transcranial Doppler have a central role in diagnosing and predicting embolic phenomena’s risk in patients with infective endocarditis, and in the initial evaluation, prognosis, and follow-up of stroke, respectively.
Main Authors:Paz, Joana
Subject:Acidente vascular cerebral cardioembólico Doppler transcraniano Ecocardiografia Endocardite infecciosa Cardioembolic stroke Echocardiography Infective endocarditis Transcranial Doppler
Year:2013
Country:Portugal
Document type:article
Access type:unknown
Associated institution:Instituto Politécnico de Lisboa Escola Superior de Tecnologia da Saúde de Lisboa
Language:Portuguese
Origin:Saúde & Tecnologia
Description
Summary:Stroke, one of the most severe complications of infective endocarditis, is a leading cause of mortality and morbidity in developed countries. Cardioembolism is not the primary etiology but is responsible for 20% of ischemic strokes. A cerebral embolism occurs in more than 40% of cases of infective endocarditis, since the embolization of vegetations, that result from the infection of intracardiac structures, may lead to cerebral arteries occlusion and, therefore, cerebral infarction due to the absence of blood flow. The development of non-invasive techniques based on ultrasonography has widely potentiated the study of these diseases, both in cardiac and vascular areas, improving the understanding of their pathophysiological mechanisms. Echocardiography and transcranial Doppler have a central role in diagnosing and predicting embolic phenomena’s risk in patients with infective endocarditis, and in the initial evaluation, prognosis, and follow-up of stroke, respectively.

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