|When a blood clot forms in the heart and then travels through the bloodstream, it is called a cardiac embolism. A cardiac embolism that travels to the brain is especially dangerous because it can cause a stroke. People with the irregular heartbeat called atrial fibrillation are at high risk for stroke in large part because of the blood clots that can form in the heart’s left atrial appendage and then travel to the brain. To help prevent stroke, people with atrial fibrillation take blood-thinning medications and may be considered for left atrial appendage closure procedures.
Blood vessels can become blocked by progressive buildup of material in the vessel wall. This is how plaque (atherosclerosis) creates blockages. When plaque or another substance, such as a blood clot, travels through the blood stream and becomes wedged in a blood vessel because the diameter of the vessel is too small for it to pass, it is called an embolism. A cardiac embolism is an obstruction that travels from the heart to lodge in a blood vessel. An embolus can be made up of fatty material, or it can be a blood clot.
Many factors can contribute to the formation of blood clots. In atherosclerosis, for example, plaques made of fats, cholesterol and other substances build up in and on the artery walls. Over time, this buildup restricts the flow of blood through the arteries and puts stress on the heart to move blood. If the plaque ruptures, it can send materials traveling through the body. These materials can lodge elsewhere, creating a clot.
Clots can cause serious problems anywhere in the body, but they are considered to be especially dangerous when they form in the carotid arteries (which deliver blood to the brain) or in a part of the heart known as the left atrial appendage (LAA).
Blockages in the Carotid Arteries
Carotid artery disease is a serious condition that occurs when the blood vessels in the neck that carry oxygen-rich blood to the brain (the carotid arteries) become blocked with plaque. These blockages can restrict blood flow to brain tissue or promote a blood clot that may embolize and cut off blood flow entirely, causing an ischemic stroke. Identifying and treating carotid artery disease is critical in reducing the risk for stroke. Learning more about carotid artery disease is an early step in working to protect your brain’s health. You can find more information about how carotid artery disease is diagnosed and treated found in the SecondsCount Carotid Artery Disease Center.
Blood Clots in the Left Atrial Appendage
If you have atrial fibrillation, it is possible that blood sometimes collects in a portion of the heart called the left atrial appendage (LAA). Over time, the blood that has gathered in the LAA can clot. If a blood clot travels to the brain, it can cause an ischemic stroke.
How Is a Cardiac Embolism Treated?
With cardiac embolism, the first goal is to prevent the blood clots from forming in the first place. If you are at risk for blood clots, your medical team may prescribe blood-thinner medications known as anticoagulants. If the risk for blood clots is the result of a specific condition, such as atrial fibrillation (Afib or AF), then medications may be prescribed to regulate the pace or the rhythm of the heartbeat.
If your condition does not respond to these medications or if you are unable to tolerate their side effects, medical procedures are available that can reduce the frequency of the Afib episodes, treat the cells that are causing the atrial fibrillation, or prevent blood from pooling in the LAA. These therapies include: