ABSTRACT
Warren J. Manning Department of Medicine, Cardiovascular Division, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, Massachusetts, U.S.A.
Our understanding of cardiac sources of embolism has expanded greatly over the past
50 years. During the 1950s, the only two cardiac disorders that were accepted as risk
factors for embolism were rheumatic mitral stenosis in combination with atrial fibrillation
and recent myocardial infarction. We now know that many cardiac conditions increase
risk of cardiac thrombosis and embolism (1,2). Advances in cardiac imaging [echocardiogra-
phy and, more recently, cardiovascular magnetic resonance and cardiac computed tomo-
graphy (CT)] and the expanding data derived from large epidemiologic studies (e.g., the
Framingham Heart Study) and large prospective clinical trials have made it possible
during the past three decades to noninvasively diagnose cardiac disorders more definitively
and to attempt to estimate the risk of embolism and benefit of specific therapies.
