Stroke is a leading cause of death and disability. Medical complications after ischemic stroke contribute substantially to poor stroke outcomes.
Pulmonary embolism (PE) is a serious medical condition whose annual incidence rate of 0.50 to 0.69 per 1000 persons in the general population. The high mortality rate of PE with case fatality at 3 months ranging between 8.6% and 17%.
Longer‐term mortality rate can be as high as 24%. The risk of pulmonary embolism, including fatal cases, in patients with acute ischemic stroke (AIS) is well known.
Studies have suggested that an increased risk of stroke among patients with acute pulmonary embolism (PE) which is thought to be due to paradoxical embolism via a patent foramen ovale (PFO). In a recent prospective study of patients with acute PE, stroke was diagnosed in 8 percent (8%), with a higher rate (21 percent) among those with a PFO. However, the exclusion of some patients from the analysis and a lower-than-expected rate of PFO than in the general population suggest that these results may be flawed. There are some limitations in available data, routinely contrast echocardiography not performing (transthoracic or transesophageal) or brain imaging in patients with acute PE, but rather adopt a symptom-directed approach to imaging.
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