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One-quarter of patients have more than one cardiac source of embolism and 15% have significant cerebrovascular atherosclerosis. After a careful work-up, up to 30% of ischaemic strokes remain \u2018cryptogenic\u2019, recently redefined as \u2018embolic strokes of undetermined source\u2019. The diagnosis of cardioembolic stroke remains difficult because a potential cardiac source of embolism does not establish the stroke mechanism. The role of cardiac imaging\u2014transthoracic echocardiography (TTE), transoesophageal echocardiography (TOE), cardiac computed tomography (CT), and magnetic resonance imaging (MRI)\u2014in the diagnosis of potential cardiac sources of embolism, and for therapeutic guidance, is reviewed in these recommendations. Contrast TTE\/TOE is highly accurate for detecting left atrial appendage thrombosis in patients with atrial fibrillation, valvular and prosthesis vegetations and thrombosis, aortic arch atheroma, patent foramen ovale, atrial septal defect, and intracardiac tumours. Both CT and MRI are highly accurate for detecting cavity thrombosis, intracardiac tumours, and valvular prosthesis thrombosis. Thus, CT and cardiac magnetic resonance should be considered in addition to TTE and TOE in the detection of a cardiac source of embolism. We propose a diagnostic algorithm where vascular imaging and contrast TTE\/TOE are considered the first-line tool in the search for a cardiac source of embolism. CT and MRI are considered as alternative and complementary tools, and their indications are described on a case-by-case approach.<\/jats:p>","DOI":"10.1093\/ehjci\/jeab008","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T15:18:18Z","timestamp":1610723898000},"page":"e24-e57","source":"Crossref","is-referenced-by-count":70,"title":["EACVI recommendations on cardiovascular imaging for the detection of embolic sources: endorsed by the Canadian Society of Echocardiography"],"prefix":"10.1093","volume":"22","author":[{"given":"Ariel","family":"Cohen","sequence":"first","affiliation":[{"name":"Assistance Publique-H\u00f4pitaux de Paris, Saint-Antoine and Tenon Hospitals, Department of Cardiology, and Sorbonne University , Paris,","place":["France"]},{"name":"INSERM unit UMRS-ICAN 1166; Sorbonne-Universit\u00e9 , Paris,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwan","family":"Donal","sequence":"additional","affiliation":[{"name":"University of Rennes, CHU Rennes , Inserm, LTSI \u2212 UMR 1099, F-35000 Rennes,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Delgado","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Leiden,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Pepi","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Via Parea 4, 20141, Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Tsang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of British Columbia , Vancouver, British Columbia,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Gerber","sequence":"additional","affiliation":[{"name":"Service de Cardiologie, D\u00e9partement Cardiovasculaire, Cliniques Universitaires St. Luc, Division CARD, Institut de Recherche Exp\u00e9rimental et Clinique (IREC) , UCLouvainAv Hippocrate 10\/2803, B-1200 Brussels,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie","family":"Soulat-Dufour","sequence":"additional","affiliation":[{"name":"Assistance Publique-H\u00f4pitaux de Paris, Saint-Antoine and Tenon Hospitals, Department of Cardiology, and Sorbonne University , Paris,","place":["France"]},{"name":"INSERM unit UMRS-ICAN 1166; Sorbonne-Universit\u00e9 , Paris,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilbert","family":"Habib","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ, IRD, MEPHI, IHU-M\u00e9diterran\u00e9e Infection, APHM, La Timone Hospital, Cardiology Department , Marseille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizio","family":"Lancellotti","sequence":"additional","affiliation":[{"name":"University of Li\u00e8ge Hospital, GIGA Cardiovascular Sciences, Department of Cardiology , CHU SartTilman, Li\u00e8ge,","place":["Belgium"]},{"name":"Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, and Anthea Hospital , Bari,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Evangelista","sequence":"additional","affiliation":[{"name":"Servei de Cardiologia. Hospital Universitari Vall d'Hebron-VHIR. CIBER-CV. P\u00ba Vall d\u2019Hebron 119. 08035 . Barcelona.","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibiana","family":"Cujec","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Alberta, 2C2.50 Walter Mackenzie Health Sciences Center , 8440 112 St NW, Edmonton, Alberta, T6G 2B7","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nowell","family":"Fine","sequence":"additional","affiliation":[{"name":"University of Calgary, Libin Cardiovascular Institute, South Health Campus, 4448 Front Street Southeast , Calgary, Alberta T3M 1M4,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Joao","family":"Andrade","sequence":"additional","affiliation":[{"name":"Maria Joao Andrade Cardiology Department, Hospital de Santa Cruz-Centro Hospitalar Lisboa Ocidental , Av. Prof. Dr. Reinaldo dos Santos 2790-134 Carnaxide,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muriel","family":"Sprynger","sequence":"additional","affiliation":[{"name":"Department of Cardiology-Angiology, University Hospital Li\u00e8ge , Li\u00e8ge,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Dweck","sequence":"additional","affiliation":[{"name":"British Heart Foundation, Centre for Cardiovascular Science, Edinburgh and Edinburgh Imaging Facility QMRI, University of Edinburgh ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thor","family":"Edvardsen","sequence":"additional","affiliation":[{"name":"Faculty of medicine, Oslo University, Oslo, Norway and Department of Cardiology, Oslo University Hospital , Rikshospitalet, Oslo,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan A","family":"Popescu","sequence":"additional","affiliation":[{"name":"Cardiology Department, University of Medicine and Pharmacy 'Carol Davila', Emergency Institute for Cardiovascular Diseases 'Prof. Dr. C. 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Fundeni 258, sector 2, 022328 Bucharest,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Reviewers: This document was reviewed by members of the 2018\u20132020 EACVI Scientific Documents Committee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Bertrand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Galderisi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina H","family":"Haugaa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leyla Elif","family":"Sade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Stankovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the chair of the 2018\u20132020 EACVI Scientific Documents Committee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Cosyns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,3,12]]},"reference":[{"key":"2026080909264283100_jeab008-B1","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1161\/01.STR.24.7.976","article-title":"Major depression in stroke patients. 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