TTE, TEE, TCD, cardiac MRI, or cardiac CT. CLINICAL STATEMENTS AND GUIDELINES Kleindorfer Recommendation-Specific Supportive Text 1. An ECG is a simple, noninvasive means of diag- nosing AF in patients with acute stroke. A meta- analysis through 2014 found that the proportion of patients diagnosed with poststroke AF in the emergency department by electrocardiography An ECG can also detect pertinent comorbidities that may have thera- peutic implications. About 3% of patients present- ing with acute stroke also have acute myocardial 2. Effective secondary prevention requires timely evalua- tion of stroke mechanism, with the intent of identifying modifiable risk factors. The risk of recurrent stroke in the short term and long term varies by stroke mech- The risk of stroke within 90 days after a first stroke is 5%, but the risk can vary greatly from >10% to <1%, depending in part on mechanism.42 Symptomatic carotid stenosis and AF are important to diagnose in a timely fashion to allow implementation of specific treatments with proven efficacy. 3. Because patients with symptomatic high-grade cervical carotid stenosis are candidates for revas- cularization, it is appropriate to screen for stenosis in any patient who may have such stenosis. Initial testing for carotid stenosis should be done with a noninvasive test such as CTA, MRA, or ultrasonog- raphy rather than digital subtraction angiography, with case series finding a risk of stroke ranging Experienced stroke cen- ters typically have a risk of stroke attributable to digital subtraction angiography of <0.5%. 