EVALUATION OF TRANSTHORACIC AND TRANSESOPHAGEAL ECHOCARDIOGRAPHIC FINDINGS IN ACUTE ISCHEMIC STROKE

Abstract

Objective: Approximately 20% of all Ischemicstrokes are the result of an embolus originatingfrom the heart. Transthoracic echocardiography(TTE) has long been used to evaluate the cardiacsource of emboli but recently transesophagealechocardiography (TEE), which has higher yieldfor detecting left atrium, aortic arch and left atrialappendage lesions, Is recommended for theassessment of patients with clinical risk factorsfor cardioembolism or unexplained stroke.Methods: In this study, the diagnostic yield ofTTE and TEE for detecting potential cardiacsources of the embolus was compared in 46consecutive patients (26 men and 20 women,aged 23-84 years) with transient ischemic attack(TIA) or acute ischemic stroke.Results: TTE revealed a potential cardiacsource of embolism in 12 (26%) patients, all ofwhom had clinical evidence of heart disease,TEE detected potential cardiac sources ofembolism in 32 (69%) patients; 7 (21%) of thesehad no clinical evidence of heart disease.Conclusion: TEE is a superior technique to TTEfor identifying potential cardiac source of theembolus and should be recommended for earlymanagement and prevention of further stroke inpatients with underlying heart disease orunexplained cerebrovascular accident.Key Words: Ischemic stroke, Transthoracicechocardiography, Transesophagealechocardiography, Cardiac source of embolism.