Cardiology

Vascular Neurology

Questions discussed in this category

What genetic testing would you consider for recurrent arterial events (cryptogenic strokes, MI) in patients with limited risk factors?

Family history is notable for CVA and early onset MI in nonsmokers, but no personal or family history of VTE. APLS testing is negative. Previously fou...

1 Answer available

How do you counsel patients on wearable heart monitor devices when they ask about specific products and diagnostic accuracy of these devices available on the market?

2 Answers available

For which stroke patients, if any, do you recommend implantable loop recorder for long-term cardiac monitoring and why?

It seems clear that longer monitoring yields more AF detected. What is less clear to me is whether all ILR-detected AF is relevant and merits anticoag...

4 Answers available

Should systemic anticoagulation be considered for patients with a less than 1% atrial fibrillation burden on outpatient monitoring with an elevated CHADSVASc score and acceptable bleeding risk?

2 Answers available

How do you manage patients with atrial fibrillation having a thromboembolic infarct despite being on adequate anticoagulation?

Would you recommend left atrial appendage occlusion with or without continuing anticoagulation? In light of Maarse et al., JAMA Neurology 2024.

3 Answers available

In ischemic stroke patients with low LDL levels (<30-50 mg/dl), would you consider lowering LDL levels to lower values without concern for any side effects?

How would you adjust statin therapy in these patients?

3 Answers available

What factors would influence your decision to use or avoid heparin bridging in patients with mechanical heart valves resuming anticoagulation after intracerebral hemorrhage?

In light of a publication by Sakusic et al., PMID 39102615 suggests an increased risk of ICH expansion in patients with heparin bridge compared to sta...

1 Answer available

What is your approach to secondary stroke prevention in patients with atrial fibrillation and intracranial stenosis (>70%)?

4 Answers available

How do you approach long-term blood pressure parameters in ischemic stroke patients with severe symptomatic intracranial stenosis?

How do you balance between having a higher long-term blood pressure to prevent flow failure and leading to worsening of stenosis or occlusion from the...

2 Answers available

Can bleeding risk when switching from VKA treatment to a NOAC in frail, elderly patients be accurately compared if individual times in therapeutic range while on VKA treatment are not captured?

Individual times in the therapeutic range while on VKA treatment was not registered in FRAIL-AF.

2 Answers available

Would you change an elderly, frail patient with atrial fibrillation who is already on a NOAC to VKA treatment?

In FRAIL-AF, switching VKA therapy to a NOAC was associated with higher risk of bleeding in elderly, frail patients.

4 Answers available

Do you consider bleeding risk in elderly, frail patients with atrial fibrillation to be similar for all NOACs?

In FRAIL-AF, participants were switched from VKA to dabigatran, rivaroxaban, apixaban, and edoxaban.

2 Answers available

Do you think that home INR monitoring is a feasible option for elderly, frail patients with atrial fibrillation on VKA treatment, given variations in socioeconomic status and access to care?

2 Answers available

Do you usually recommend PFO closure for patients with frequent migraines with aura?

1 Answer available

How do you approach a patient with atrial fibrillation on apixaban who has a new cardioembolic stroke?

3 Answers available

In patients with Afib on anticoagulation and concurrent intracranial atherosclerotic disease, would you consider adding an anti-platelet to anticoagulation if there are recurrent events that could be related to the ICAD?

1 Answer available

Does the presence and location of cerebral microbleeds affect your decision for antithrombotic treatment in patients with atrial fibrillation?

Do you distinguish between primary and secondary prevention? Wilson et al., PMID 31130428 is helpful, but curious how people apply this data in practi...

3 Answers available

Would you recommend PFO closure in patients >60 years old with presumed paradoxical embolism as their mechanism of stroke?

2 Answers available

When would you consider obtaining a cardiac CT in lieu of standard TEE for the detection of a left atrial appendage thrombus in atrial fibrillation?

2 Answers available

Would you favor restarting anticoagulation or pursuing left atrial appendage closure in a patient with hemorrhagic stroke on anticoagulation for non-valvular atrial fibrillation?

3 Answers available

When do you start anticoagulation in a patient with cardioembolic CVA secondary to new onset atrial fibrillation with hemorrhagic conversion?

1 Answer available

How does evidence of cerebral amyloid angiopathy/microbleeds affect choices for secondary stroke prevention in patients with a history of ischemic stroke and atrial fibrillation?

How do you approach secondary stroke prevention for patients with ischemic stroke, atrial fibrillation, and signs of cerebral amyloid angiopathy/micro...

1 Answer available

Do you start anticoagulation in a patient with infective endocarditis who also has atrial fibrillation and stroke?

1 Answer available

For patients with atrial fibrillation on DOAC, when should they resume DOAC after a thalamic bleed without intraventricular bleed?

How does presence of intraventricular hemorrhage change your recommendations?

2 Answers available

When do you start anticoagulation for secondary prevention in patients with HFrEF and history of embolic strokes?

For a relatively young, medically compliant patient with HFrEF (EF<35%) and h/o embolic stroke, what is the consensus of starting AC for secondary ...

1 Answer available

When is the best time to consider left atrial appendage closure for secondary stroke prevention in patients with atrial fibrillation?

For example, with a Watchman device? What is the evidence behind this?

1 Answer available

When do you restart anticoagulation in patients with atrial fibrillation who just had an ischemic stroke?

1 Answer available

How do you determine the timing of anticoagulation for patients with large MCA strokes secondary to atrial fibrillation?

1 Answer available