Intra-cardiac thrombus detection by electrocardiogram-gated cardiac computed tomography in hyperacute ischemic stroke
By
Daniel S. Green
Timmy Pham
Dennis J. Cordato
Longting Lin
Daniel Akrawi
Callan Gavaghan
Chilan Nguyen
Aaron Gaekwad
Alan McDougall
Carlos Garcia-Esperon
Anthony Kaplan
Christopher Blair
Melissa Leung
Mark W. Parsons
June 24, 2026
Clinical Scorecard: Detection of Intra-cardiac Thrombus in Hyperacute Ischemic Stroke Using Electrocardiogram-Gated Cardiac Computed Tomography
At a Glance
Category Detail
Condition Ischemic Stroke Key Mechanisms Detection of intra-cardiac thrombus using ECG-gated cardiac CT. Target Population Patients with suspected cardioembolic stroke. Care Setting Hyperacute stroke imaging protocol.
Key Highlights
ECG-gated cardiac CT identified intra-cardiac thrombus in 26% of ischemic stroke patients. Higher prevalence of premorbid hypertension, heart failure, and atrial fibrillation in patients with intra-cardiac thrombus. Cardiac CT had a significantly higher detection rate of intra-cardiac thrombus compared to TTE (29% vs. 2%). Poor functional outcomes at 3 months were more common in patients with intra-cardiac thrombus. Guideline-Based Recommendations
Diagnosis
Consider ECG-gated cardiac CT as part of hyperacute stroke imaging protocols. Management
Monitoring & Follow-up
Risks
Patient & Prescribing Data
Patients over 18 years with stroke syndrome potentially eligible for reperfusion therapy.
Further studies are required to explore benefits in different populations.
Clinical Best Practices
Utilize ECG-gated cardiac CT for early detection of intra-cardiac thrombus in hyperacute ischemic stroke. Related Resources & Content
