Many Docs Feel Uninformed About Cryptogenic Stroke

Megan Brooks

October 14, 2015

Only about half of health professionals in the United States feel adequately prepared to deal with patients with cryptogenic stroke, according to a survey by the American Heart Association (AHA) and the American Stroke Association (ASA).

The online survey asked 652 neurologists, cardiologists, hospitalists, primary care physicians, and stroke coordinators about the degree to which they felt adequately informed about cryptogenic stroke, which occurs in the absence of a clearly established cause.

Depending on their specialty, between 51% and 70% of respondents said they are uncertain about the optimal approaches to pinpoint the underlying cause of cryptogenic stroke, the AHA/ASA reports in a news release.

A "notable" segment of healthcare professionals are uninformed about cryptogenic stroke (3 in 10 neurologists and cardiologists feel only somewhat informed or not informed), they note.

And many are not overly confident their prescribed treatment will prevent a secondary stroke (between 32% and 46% extremely/very confident), the survey shows. Nearly 6 in 10 neurologists and cardiologists feel only somewhat or not confident treatment will prevent another stroke.

Atrial fibrillation is "top of mind" among healthcare professionals as a potential cause of cryptogenic stroke. Nine in 10 said it's important to look for atrial fibrillation but many find "challenges" in detecting atrial fibrillation. Eight in 10 providers consider outpatient cardiac monitoring "valuable" in cryptogenic stroke.

In addition to atrial fibrillation, other common causes of cryptogenic stroke that "should be investigated" include patent foramen ovale, and various forms of blood clotting disorders, the AHA/ASA notes in a news release.

While most healthcare providers surveyed said they use the term "cryptogenic" when discussing stroke of unknown cause with each other, few use it when talking with patients, opting instead for the more consumer-friendly "stroke of undetermined cause" terminology.

The survey results were released October 9 at the AHA/ASA-sponsored Cryptogenic Stroke Public Health Conference in Washington, DC.

Each year, about 200,000 Americans have a stroke with no apparent explanation. Not knowing the cause can hamper efforts to provide optimal treatments to prevent a second stroke.

"The ability to discern the causes of cryptogenic strokes has profound implications for preventing secondary strokes and improving patient outcomes," Mary Ann Bauman, MD, chair of the ASA's advisory committee, said in the news release.

The goal of the Cryptogenic Stroke Public Health Conference, she said, is to "increase our knowledge about cryptogenic stroke and improve treatment. This is important because stroke is the fifth leading cause of death in the U.S. and a leading cause of severe, long-term disability."

More information about cryptogenic stroke, as well as a healthcare provider guide and patient guide, is available at strokeassociation.org/cs.

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