Usefulness of spectral cardiac computed tomography for the evaluation of thrombotic complications in patients with ischemic stroke

Objective: The aim of this study was to evaluate the usefulness of spectral cardiac computed tomography (CT) angiographyin patients with ischemic stroke. Methods: In the setting of COVID-19 pandemic, we incorporated the use of spectral cardiac CT in patients with ischemicstroke to rule out the presence of cardioembolic sources, thrombotic complications or myocardial damage in a single session.Since July 2020, a delayed-phase image acquisition was incorporated to cardiac CT scans in the context of ischemic stroke.We describe four representative cases of the usefulness of the method and the cardiovascular findings. Results: We present four cases recorded recorded within a 40-day period. Two patients with patients with cardioembolic source(aorta and left atrial appendage) and two with ischemic stroke of undetermined source with evidence of cardiomyopathy(ischemic and non-ischemic). Conclusions: In the setting of ischemic stroke, spectral cardiac CT with delayed acquisition could be useful to rule out thepresence of cardioembolic sources and identify the underlying etiology.