How Would You Prevent Subsequent Strokes in This Patient? Grand Rounds Discussion From Beth Israel Deaconess Medical Center

Annals Beyond the Guidelines

Stroke is a major cause of morbidity, mortality, and disability. The American Heart Association/American Stroke Association recently published updated guidelines on secondary stroke prevention. In these rounds, 2 vascular neurologists use the case of Mr. S, a 75-year-old man with a history of 2 strokes, to discuss and debate questions in the guideline concerning intensity of atrial fibrillation monitoring in embolic stroke of undetermined source, diagnosis and management of moderate symptomatic carotid stenosis, and therapeutic strategies for recurrent embolic stroke of undetermined source in the setting of guideline-concordant therapy.


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Annals Beyond the Guidelines

From Annals of Internal Medicine (, Beyond the Guidelines is an educational feature based on recent guidelines. Each considers a patient (or patients) who "falls between the cracks" of available evidence and for whom the optimal clinical course in unclear. Presented at Beth Israel Deaconess Medical Center (BIDMC) Grand Rounds, each conference reviews the background evidence and experts then discuss the patient(s) and field audience questions. Videos of the interviews and conference, the slide presentation, and a CME/MOC activity accompany each module.