Highlights
- •Imaging is needed to differentiate TIA and ischemic stroke.
- •Pathognomonic clinical or imaging features of cardioembolic stroke are lacking.
- •Prognosis is worse after atrial fibrillation-related ischemic stroke.
- •The optimal timing of starting anticoagulation after ischemic stroke is unknown.
Abstract
Strokes, whether ischaemic or haemorrhagic, are the most feared complications of atrial
fibrillation (AF) and its treatment. Vitamin K antagonists have been the mainstay
of stroke prevention. Recently, direct oral anticoagulants have been introduced. The
advantages and disadvantages of these treatment strategies have been extensively discussed.
In this narrative review, we discuss dilemmas faced by primary care clinicians in
the context of stroke and transient ischaemic attack (TIA) in patients with AF. We
discuss the classification of stroke, the different types of stroke seen with AF,
the prognosis of AF-related strokes, the early management after AF-related stroke
or TIA and the therapeutic options after anticoagulant-associated intracerebral haemorrhage.
Most importantly, we aim to dispel common misconceptions on the part of non-stroke
specialists that can lead to suboptimal stroke prevention and management.
Keywords
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Article info
Publication history
Published online: July 08, 2015
Accepted:
June 16,
2015
Received in revised form:
June 15,
2015
Received:
November 18,
2014
Identification
Copyright
© 2015 European Federation of Internal Medicine. Published by Elsevier Inc. All rights reserved.
