Table 8. Cardiac Pathology (C) of the ASCOD Classification with Causality Grades [8].

A table was created representing the different causality grades, as an underlying etiology of ischemic stroke as per a subcategory of the ASCOD classification [8].

ASCOD: atherothrombosis, small vessel disease, cardiac pathology, other causes, and dissection classification; PFO: patent foramen ovale; DVT: deep venous thrombosis; ASA: atrial septal aneurysm; ECG: electrocardiogram; TEE: transesophageal echocardiography; TTE: transthoracic echocardiography; CT: computed tomography; MRI: magnetic resonance imaging.

The Causality Grades [8]	ASCOD Cardiac Pathology (C) Disease Phenotypes According to Classification [8]
C1: potentially causal. A stroke that is cardiogenic is defined as an ischemic lesion and has signs of systemic embolism with detection of at least one of the following causes:	Mitral stenosis, mechanical valve, myocardial infarction within four weeks, preceding the cerebral infarction, mural thrombus in the left cavities, aneurysm of the left ventricle, a history or presence of documented atrial fibrillation (either paroxysmal, persistent or permanent) or atrial flutter with or without left atrial thrombus or spontaneous echo, atrial disease (tachycardia-bradycardia syndrome), dilated or hypertrophic cardiomyopathies, left ventricle ejection fraction <35%, endocarditis, intracardiac mass, PFO and thrombus in situ, PFO and concomitant pulmonary embolism or proximal DVT preceding the index cerebral infarction, aforementioned cardiac pathologies (C1) with single or without obvious cerebral ischemic lesion
C2: the causal link is uncertain. Regardless of the cardiogenic stroke pattern, there may be:	PFO + atrial septal aneurysm.	PFO and pulmonary embolism or proximal DVT concomitant but not preceding the index cerebral infarction.		An intracardiac spontaneous echo contrast.		Apical akinesia of the left ventricle and decreased ejection fraction (but >35%) in the patient.	A history of myocardial infarction or palpitation, and multiple brain infarction, repeated either bilaterally or in two different arterial territories.	No direct cardiac source identified but multiple brain infarctions present and/or evidence of systemic emboli.
C3: the causal link is unlikely, but the disease is present. It is defined as potentially one of the following:	PFO, ASA, strands, mitral annulus calcification, calcification aortic valve, non-apical akinesia of the left ventricle, transient atrial fibrillation less than 1 minute in duration, atrial hyperexcitability.
C0: cardiac pathology is neither detected nor suspected. Workup needed to rule out cardiac pathology:	The minimum workup needed is a negative ECG and an examination by a cardiologist.				The maximum workup needed is a negative ECG/telemetry/24-hour Holter ECG/long-term ECG recording, a negative TEE, a negative TTE for PFO and assessment of left ventricle, a negative cardiac CT/MRI, and a negative abdominal CT/MRI.
C9: an incomplete workup done on the patient. Minimum workup needed to rule out cardiogenic shock:	ECG		An examination by a trained cardiologist in the absence of cardiac imaging.