Table II.

Cardioaortic Sources of Cerebral Embolism According to the SSS TOAST Classification [37]

Sources with High Primary Risk for Ischemic Stroke

Sources of embolism of thrombotic origin

-Left atrial thrombus

-Left ventricular thrombus

-Atrial fibrillation

-Paroxysmal atrial fibrillation

-Sick sinus syndrome

-Sustained atrial flutter

-Recent myocardial infarction (within 1 month)

-Rheumatoid mitral or aortic valve disease

-Bioprosthetic and mechanical heart valves

-Chronic myocardial infarction together with low ejection fraction less than 28%

-Symptomatic congestive heart failure with ejection fraction less than 30%

-Dilated cardiomyopathy

-Nonbacterial thrombotic endocarditis

Sources with embolism not predominantly of thrombotic origin

-Infective endocarditis

-Papillary fibroelastoma

-Left atrial myxoma

Sources with Low or Uncertain Primary Risk for Ischemic Stroke

Cardiac sources of embolism

-Mitral annular calcification

-Patent foramen ovale

-Atrial septal aneurysm

-Atrial septal aneurysm and patent foramen ovale

-Left ventricular aneurysm without thrombus

-Isolated left atrial smoke (no mitral stenosis or atrial fibrillation)

Aortic sources of embolism

-Complex atheroma in the ascending aorta or proximal arch