Except in Cases of Atrial Fibrillation, What Are the Theoretical Indications of Oral Anticoagulants in the Prevention of Stroke?
Oral anticoagulation should be considered with well-established causes of potential cardiac sources of embolism. However, long-term anticoagulants are used on an empirical basis in patients with rheumatic valvular heart disease, mechanical prosthetic heart valves, and other major cardiac sources of embolism, though evidence from properly randomized trials is scanty or nonexistent. The diagnosis of an embolism from the heart remains impre-cise, because it is based mainly on clinical criteria. It seems that about 20% of all TIA or ischemic strokes in patients are of cardioembolic cause. The most common causes of cardioembolic stroke are nonvalvular atrial fibrillation (NVAF) (60%), ischemic heart disease (30%), nonrheumatic valvular heart disease (30%) and rheumatic heart disease (10%). In many cases, NVAF complicates a structural disease of the heart. Cardiac sources of potential embolism are: Prosthetic Heart Valves The risk of systemic embolism is greater with mechanical than with bio
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