7 Habits to Reduce the Risk of Cryptogenic Stroke - Oren Zarif - Cryptogenic Stroke
One in three strokes is ischemic, but the incidence of cryptogenic stroke is even higher. The stroke risk increases five-fold for people with irregular heartbeats (AFib), including cryptogenic stroke. People with AFib should discuss the treatment options with their physician, which may include blood workups and diagnostic testing. Lifestyle changes may also be helpful. These seven habits can help you reduce the risk of cryptogenic stroke. You should consult your physician immediately if you suspect you are having a cryptogenic stroke.
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One of the biggest challenges in the treatment of patients with cryptogenic stroke is the lack of reliable diagnosis. Cryptogenic strokes can also be caused by other conditions, including atrial fibrillation. Patients with intermittent AF may not be diagnosed as having a stroke, and continuous monitoring of AF may help identify fewer cases of cryptogenic stroke. The development of wearable devices may make this easier, as they don't require as much monitoring.
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An electrocardiogram is recommended for all patients who have a stroke. An additional 24 hours of cardiac monitoring is required in cases with no clear small-vessel mechanism. A transthoracic or transoesophageal echocardiogram can be performed to identify structural cardiac causes of cryptogenic stroke. Other basic laboratory tests should be performed to assess coagulopathy and common modifiable risk factors. And if you suspect cryptogenic stroke, you should consider getting an MRI of your heart.
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A computerized algorithm called ASCOD has been created to help doctors differentiate between the causative and phenotypic subtypes of stroke. The ASCOD scores these five major stroke categories based on their likelihood of causation. In addition to determining the likelihood of a particular cause, ASCOD also grades the presence or absence of disease, and insufficient workup. ASCOD has become a valuable tool in diagnosing stroke patients.
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Although there is no definitive cause for cryptogenic stroke, cardioembolic mechanisms have been studied extensively. While they are not always well-documented, they may be important contributors to cryptogenic stroke. Other causes of cryptogenic stroke include high blood pressure, smoking, and heart disease. They are common and may contribute to cryptogenic stroke. For this reason, a proper diagnostic workup is vital to minimize the risk of another stroke. In addition to lowering the risk of cryptogenic stroke, you can also decrease your chance of another stroke by learning the cause of the original one.
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Acute ischemic stroke is usually divided into five subtypes: cardioembolic, occlusive small vessels, and undetermined. However, if the symptoms persist, you should seek a second opinion. Your doctor may be able to diagnose cryptogenic stroke by using a biomarker, if necessary. The best option for you is to have a second opinion. There are several different methods of treating cryptogenic stroke.
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In general, continuous electrocardiographic monitoring with ICMs is better than intermittent strategies. Holter monitoring, serial electrocardiography, and long-term outpatient monitoring are all viable options. Nevertheless, intermittent monitoring has limited yield. Some studies have shown that long-term monitoring can detect paroxysmal AF more effectively than conventional follow-up. Several studies have demonstrated the effectiveness of long-term monitoring of patients with atrial fibrillation.
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While this finding does not prove a causal relationship, the high incidence of PFO in cryptogenic stroke patients suggests that there is a PFO-related mechanism. Moreover, this is true for only 50% of cryptogenic stroke patients, so it is important to rule out other potential causes before identifying a cause. The same applies for etiological studies. The authors recommend that doctors investigate PFO-related cryptogenic stroke patients and determine whether it is the cause of the symptoms.
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As mentioned above, the mechanisms that cause CS vary, but the most common ones involve the cardiac system. Therefore, a complete evaluation of the patient's cardiac system is necessary to identify the actual cause of cryptogenic stroke and develop an effective secondary prevention strategy. The authors have included their personal disclosures in the manuscript. They report no other conflicts of interest. While the authors acknowledge financial relationships with various companies, none reported conflicts of interest. However, they do accept payment for their services.