Stroke, Vol 25, 23-28, Copyright © 1994 by American Heart Association
GW Albers, KA Comess, FA DeRook, P Bracci, JE Atwood, A Bolger and J Hotson
BACKGROUND AND PURPOSE--Transesophageal echocardiography has a high yield
for detecting potential cardiac sources of embolism in patients with
clinical risk factors for cardioembolism or unexplained stroke. The yield
in other stroke subtypes is unknown. METHODS--We classified 145
consecutively admitted patients into stroke subtypes based on clinical
findings, brain imaging, and carotid ultrasound. Both transesophageal and
transthoracic echocardiography were performed to detect left atrial
thrombi, spontaneous echo contrast, atrial septal aneurysm, interatrial
shunts, ventricular thrombus or aneurysm, and myxomatous mitral valve.
RESULTS--Transesophageal echocardiography documented at least one of these
findings in 46% of the patients compared with an 8% yield on the
transthoracic study (P = .002). The yield of transesophageal
echocardiography was substantial in all stroke subgroups. Patients with
clinical risk factors for cardiac embolism had the highest frequency of
spontaneous echo contrast (P = .001). Atrial septal aneurysms were most
frequent in patients with lacunar syndromes (P = .012), and interatrial
shunts were common in all stroke subtypes. CONCLUSIONS--Transesophageal
echocardiographic findings vary considerably between stroke subgroups.
ARTICLES
Transesophageal echocardiographic findings in stroke subtypes
Stanford Stroke Center, Palo Alto, CA 94304-1705.
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