Criptogenic stroke: how cardiology can help solve a neurological puzzle

This article analyzes the cardiological aspects of the etiology of cryptogenic stroke, including ESUS (embolic stroke of undetermined source). Special attention is paid to the pathophysiological mechanisms and risk factors for the development of cardioembolism in the absence of instrumentally confirmed atrial fibrillation. Several key areas are considered in detail: atrial cardiopathy as a complex of structural and functional changes in the left atrium, a subclinical form of atrial fibrillation and aorto-arterial embolism caused by non-stenosing atherosclerotic plaques, intracranial atherosclerosis and atheromatosis of the aortic arch. A comprehensive analysis of modern diagnostic biomarkers is presented, including instrumental (P-wave terminal force in lead V1 — PTFV1, supraventricular arrhythmias, indicators of structural changes in the left atrium) and laboratory ones (N-terminal pro-B-type natriuretic peptide, troponin, D-dimer), which identify the hidden embologenic substrate. New diagnostic approaches are highlighted, including advanced electrocardiographic monitoring protocols, echocardiographic techniques, and advanced vascular imaging techniques. The need for a comprehensive early diagnostic protocol implemented as part of a personalized approach is emphasized.

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