0331-News-Stroke ER visits_Blog

A new guide has been created to help healthcare professionals better understand and diagnose strokes of unknown cause.

The free resource is part of an American Heart Association/American Stroke Association initiative in collaboration with Medtronic plc which aims to reduce the rate of recurrent strokes in the U.S.

Every year, nearly 800,000 Americans have a stroke, the fifth leading cause of death and a primary cause of disability. The most common type of stroke, called “ischemic,” occurs when blood vessels carrying oxygen and nutrients to the brain are blocked by a clot causing brain cells to die. Thirty percent of ischemic strokes have no known cause, even after thorough diagnostic tests are performed during a stroke patient’s hospitalization. These strokes of uncertain origin are deemed “cryptogenic.”

The Cryptogenic Stroke Guide for Healthcare Professionals includes information on diagnostic evaluation and details the many potential causes of cryptogenic stroke, like atrial fibrillation.

People with atrial fibrillation — a common heart condition where the heart beats irregularly or rapidly — are five times more likely to have a stroke, but their condition often goes undiagnosed because episodes occur infrequently and are often not detected by conventional monitoring techniques.

“Recent evidence suggests that up to 30 percent of patients with cryptogenic stroke will demonstrate intermittent atrial fibrillation during prolonged heart rhythm monitoring after the stroke,” said Lee H. Schwamm, M.D., an ASA volunteer spokesperson, executive vice chairman, department of neurology, and director of stroke services at Massachusetts General Hospital. “As insertable cardiac monitors have become more readily available and convenient, they will likely play an increasingly important role in identifying or excluding the presence of atrial fibrillation, or other arrhythmias, in patients with cryptogenic ischemic stroke.”

The guide includes the following sections:

  • Background information on cryptogenic stroke;
  • Suggested diagnostic approaches;
  • Treatment pathways that factor in the complexity of identifying potential causes; and
  • Case studies.

The Cryptogenic Stroke Initiative was announced in February at the ASA’s annual International Stroke Conference.