Cardiogenic Cerebral Embolism: Understanding the Causes

Cardiogenic cerebral embolism is a clinical condition in which blood clots formed in the heart travel to the brain, blocking blood flow and causing a stroke. It accounts for approximately 60% to 75% of all cerebral infarctions, making it one of the most common types of ischemic stroke.

Common Causes of Cardiogenic Stroke

One of the leading causes of cardiogenic stroke is atrial fibrillation (AFib), a type of irregular heartbeat that can lead to poor blood flow and clot formation within the heart. Patients with chronic AFib are especially at risk due to the altered hemodynamics that promote clot development.

Atrial Fibrillation and Stroke Risk

In patients with AFib, blood may pool in the heart's upper chambers, increasing the likelihood of clot formation. If a clot breaks loose, it can travel through the bloodstream to the brain, causing a blockage that leads to cerebral infarction. This risk is significantly higher in individuals with long-standing or untreated AFib.

Rheumatic Heart Disease in Young Adults

While AFib is a major contributor in older populations, rheumatic heart disease remains a significant cause of cerebral embolism among younger individuals. This condition, often a result of untreated streptococcal infections, can damage heart valves and increase the risk of clot formation.

Other Contributing Factors

Besides AFib and rheumatic heart disease, other cardiac conditions can also lead to cardiogenic stroke. These include myocardial infarction (heart attack), where a clot may form in the heart's blood vessels and dislodge, traveling to the brain. Additionally, mural thrombi—blood clots attached to the inner walls of the heart—are also a known cause.

Post-Surgical Complications

Patients who have undergone cardiac surgery may also be at increased risk. Complications such as post-operative arrhythmias or clot formation due to mechanical heart valves or surgical trauma can lead to embolic stroke. Close monitoring and anticoagulant therapy are often required to mitigate this risk.