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Cardiac morphology and physiology predisposing to thrombus formation

D. Horstkotte*, D. Hering, L. Faber and C. Piper

Department of Cardiology, Heart Center North Rhine-Westphalia, Ruhr University of Bochum, Bad Oeynhausen, Germany

* Correspondence: D. Horstkotte M.D., Department of Cardiology, Heart Center North Rhine-Westphalia, Ruhr University of Bochum, Bad Oeynhausen, Germany.

Abstract

Cardiogenic neurologic embolism accounts for approximately 15–20% of stroke cases. Various diseases and therapeutic interventions may predispose a patient to intra-cardiac thrombus formation and subsequent embolism. General risk factors for intra-cardiac thrombus include an abnormal endocardium, loss of atrial contraction, arrhythmias, cardiac chamber dilatation and impaired left ventricular function. The present review addresses the pathophysiological mechanisms that underlie these risk factors and their relationship to thrombus formation. In addition, the phenomenon of spontaneous echo contrast is reviewed, as is its usefulness in identifying patients who are at risk for thromboembolic complications.

Key Words: Cardiac embolism • spontaneous echo contrast • thromboembolic complications • thrombosis

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