# Cardiac Source Workup — sources and correction notes

- [AHA 2026 scientific statement: Stroke Prevention in Patients With Left Ventricular Systolic Dysfunction](https://www.ahajournals.org/doi/10.1161/STR.0000000000000528)
- [AHA/ASA 2024 Guideline for the Primary Prevention of Stroke](https://www.ahajournals.org/doi/10.1161/STR.0000000000000475)
- [AHA/ASA 2021 Guideline for the Prevention of Stroke in Patients With Stroke and TIA](https://www.ahajournals.org/doi/10.1161/STR.0000000000000375)
- [AHA 2022 Scientific Statement on Management of Patients at Risk for and With LV Thrombus](https://www.ahajournals.org/doi/10.1161/CIR.0000000000001092)
- [ASE Guideline: Cardiac Source of Embolism](https://www.asecho.org/guideline/cardiac-source-of-embolism/)
- [JAHA systematic review and meta-analysis: Cardiac CT versus TEE for LAA thrombus detection](https://www.ahajournals.org/doi/10.1161/JAHA.121.022505)

Clinical wording locked for this lesson:

- Primary prevention in LV dysfunction alone is **Class 3: No Benefit, LOE B-R**, not “harm.”
- The 2026 statement's EF below 40% or wall-motion-abnormality trigger for considering an ultrasound-enhancing agent is expert scientific-statement guidance, not a formal COR/LOE recommendation.
- Cardiac CT is a reliable alternative for LAA thrombus assessment when the protocol includes delayed imaging. That overlap does not generalize to mobile valve lesions, for which TEE remains the key test.
- Complex aortic arch plaque is a competing stroke mechanism, not an automatic indication for anticoagulation.

Visual anatomy attribution:

- Full license and build provenance: [ATTRIBUTION.md](ATTRIBUTION.md).

- The 3D cardiac anatomy in the video is a modified extract from
  [Z-Anatomy](https://github.com/Z-Anatomy/Models-of-human-anatomy), built from
  BodyParts3D structures and shared under CC BY-SA 4.0. The Lumen derivative
  recolors, isolates, and combines named cardiac structures; its apical LV
  thrombus is an original schematic overlay, not an atlas structure or patient
  image. The video does not reproduce an AHA scientific-statement figure.

For clinician education; verify against the cited guidance and individual patient context.