Heart diseases and stroke.

A heterogeneous group of heart diseases, varying by cardiac anatomy and physiology, are responsible for a variety of embolic materials that result in cerebral and systemic embolism. Atrial fibrillation accounts for nearly half of all cardioembolic stroke, particularly in the elderly, but in the young congenital septal abnormalities such as patent foramen ovale play a more important role. Therapeutic strategies include stabilization or treatment of the underlying heart disease and prevention of embolism. Oral anticoagulant therapy is indicated for many but decision making on balancing the benefits versus risks can be difficult. New endovascular therapies and devices have become available and await clinical trials that allow them to be compared with existing medical therapies.