by Carlo Raj, MD

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      Slides 01 Stroke Neuropathology I.pdf
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    Let’s talk about embolism and its pathophysiology. Atrial fibrillation. We just had this conversation. Let’s say that you have a patient who’s elderly and is suffering from or had a history of myocardial infarction. And now the patient starts having a heart rate that’s racing. Racing. Upon physical examination, the heart rate is approximately 200 beats per minute. You take a look at the electrocardiogram, you find that the P waves are pretty much non-existent or wavy in nature. At this point, you’re suspecting atrial fibrillation. And for sure, you’re worried about thrombotic formation in the heart. The next step of management, please? Prophylaxis with? Good. Prophylaxis with anticoagulant. Well done. Such as warfarin. Why? Because warfarin has shown, on current day practice, to be the most effective anticoagulant drug to prevent cerebrovascular accident. Now, granted a cerebrovascular accident could be only ten percent of the time when you embolize from the heart. The other places that you would embolize would be maybe the renal artery, maybe the superior mesenteric artery, and those are much more common, much more common. However, when it comes to warfarin, it’s important that you pay attention to atrial fibrillation and its prevention of CVA. What else? Valvular heart disease, same thing, thrombi formation. You’re always run into the risk of embolic type of focal stroke. Wall motion abnormality. What does that mean to you? Patient has suffered, let’s say, myocardial infarction or if patient has been drinking for a while and this alcohol is then causing damage to the heart. And all of these, at some point in time, you’d recognize that the patient is getting fatigued. And upon echocardiogram, you then calculate that the ejection fraction is less than 55%. What’s going on? Well, now you’ll also notice that the wall motion is...

    About the Lecture

    The lecture Embolism by Carlo Raj, MD is from the course Stroke (Cerebrovascular Accident). It contains the following chapters:

    • Embolism
    • Thrombosis
    • Arteritis
    • Definitions

    Included Quiz Questions

    1. Deep vein thrombosis
    2. Carotid artery dissection
    3. Atrial fibrillation
    4. Mitral valve cardiac vegetations
    5. Rupture of atherosclerotic plaque
    1. Bifurcation of carotid artery
    2. anterior cerebral artery
    3. vertebral artery
    4. Junction of anterior cerebellar artery and middle cerebellar artery
    5. Pituitary artery
    1. Acute blood loss
    2. Inflammation of the middle cerebral artery
    3. Thrombus formation at the bifurcation of carotid artery
    4. Embolism due to atrial fibrillation
    5. Primary CNS angitis
    1. Raynaud's disease
    2. Henoch-Schonlein purpura
    3. Microscopic polyangitis
    4. Temporal arteritis
    5. Polyarteritis Nodosa
    1. HHV 8
    2. Syphilis
    3. Tuberculosis
    4. CMV
    5. Aspergillosis
    1. Asterixis
    2. Aphasia
    3. Alexia
    4. Agraphia
    5. Ataxia

    Author of lecture Embolism

     Carlo Raj, MD

    Carlo Raj, MD

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