Would you consider empiric anticoagulation in patients with an acute stroke for whom you have high suspicion for cardioembolic source, but have not yet confirmed LV thrombus, atrial fibrillation, etc.?

In practice, I would rarely consider empiric anticoagulation after an acute ischemic stroke without a confirmed cardioembolic source. I would not consider this approach for suspected LV thrombus, as transthoracic echocardiography is routinely available in the inpatient setting and can quickly confir...

This needs to be approached with caution. If the stroke is large, there is a risk of bleeding. The general recommendations are to wait until this risk can be understood through imaging. Guidelines warn about starting AC urgently. However, in certain high-risk conditions (like known thrombus), it is ...

I agree with Dr. @Dr. First Last. I would rarely initiate anticoagulation without an embolic source on the first stroke. I would initiate a very thorough work-up, including TTE and likely TEE, cardiac monitoring, hypercoagulable state tests, etc. I have anticoagulated in the setting of a recurrent s...