Understanding Atrial Cardiopathy: an Under-Recognized Contributor to Cardioembolic Stroke

  • Michelle C. JohansenEmail author
  • Henrique Doria De Vasconcellos
  • Rebecca F. Gottesman
Cerebrovascular Disorders (D Jamieson, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Cerebrovascular Disorders


Purpose of review

Ischemic stroke is the fifth leading cause of death in the world with cardioembolic stroke (CES) causing a disproportional amount of the morbidity and mortality associated with stroke. Atrial fibrillation (AF) is the leading cause of CES, and as the population ages, the incidence of CES is anticipated to rise. The importance of proper diagnosis and treatment of patients with embolic-appearing stroke is significant due to the burden of disease and the severity of the illness.

Recent findings

The past decade has seen an explosion of treatment options for patients with CES related to AF as well as better mechanisms by which to monitor and diagnose patients with AF. While optimal secondary prevention of stroke with anticoagulation in the setting of AF is known, what remains to be defined is the appropriate treatment of other types of strokes that appear embolic, but no source of the embolism is discovered.


In this article, we will review what is known about the diagnosis and treatment of CES, discuss the emergence of novel therapeutics and emphasize what must be investigated in the future to move the field forward, such as the emerging concept of atrial cardiopathy.


Ischemic stroke Cardioembolic stroke Atrial cardiopathy Stroke treatment Stroke diagnosis 


Compliance with Ethical Standards

Conflict of Interest

Michelle C. Johansen reports grants from American Heart Association Mentored Clinical and Population Research Award and grants from NIH/ICTR KL2 Early Career Investigator Award, outside the submitted work. Henrique Doria De Vasconcellos declares no potential conflict of interest. Rebecca F. Gottesman is an Associate Editor for the journal Neurology.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Michelle C. Johansen
    • 1
    Email author
  • Henrique Doria De Vasconcellos
    • 2
  • Rebecca F. Gottesman
    • 1
  1. 1.Department of NeurologyThe Johns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of CardiologyThe Johns Hopkins University School of MedicineBaltimoreUSA

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