الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 174 |  |  |
| | | from | 174 | | |
Abstract
Stroke is the second leading cause of death world wide and the third leading cause of death in the developed world. Stroke causes over 5.5 million deaths globally every year, two thirds of which occur in the developing world. Moreover, stroke leads to higher disability adjusted life years (DALY) impact in developing countries compared to developed countries, making it a major public health issue ( Khan et al., 2008 ). Cardioembolic strokes are severe and prone to early recurrence. Embolism of material from the heart to the brain results from one of three mechanisms: thrombosis within a cardiac chamber because of local homeostasis (eg, left ventricular (LV) aneurysm); release of material from an abnormal valvular surface (eg, calcific degeneration); and abnormal passage of material from venous to arterial circulation (paradoxical embolism). Cardiac emboli can be of any size, but those arising from the cardiac chambers are often large and hence especially likely to cause severe stroke, disability and death ( Weir , 2008 ). Echocardiography is performed to identify the cardiogenic source of embolus and has been recommended as a routine test in stroke workup ( Rem et al., 1985 ). However the cost effectiveness of echocardiography in secondary prevention of stroke has generated controversy. Some investigators have recommended echocardiographic evaluation of all stroke patients ( de Abreu et al., 2005 ). Others are suggesting echocardiography based on specific indications ( Beattie et al., 1998 ).