Transesophageal echocardiography discloses unexpected cardiac sources of embolus in stroke patients aged more than 45 years.
Cerebral embolism from cardiac source is an important cause of stroke, specially in patients younger than 45 years old.


OBJECTIVE
To describe the transesophageal echocardiography (TEE) findings in young and non-young stroke patients without any prior evidence of cardiac source for cerebral embolism.


METHODS
Transversal study: 523 patients (267 men and 256 women) with ischemic stroke, without any evidence of cardiac abnormality, underwent to TEE.


RESULTS
Ten percent were aged 45 years; or less. Left ventricle hypertrophy, left atrial enlargement, spontaneous contrast in aorta, interatrial septum aneurysm, mitral and aortic valve calcification, aortic valve regurgitation, and atherosclerotic plaques in aorta were significantly more frequent in patients aged more than 45 years; 2.8% of non-young patients had thrombus in left heart.


CONCLUSIONS
TEE is widely used to diagnose cardiac source of cerebral embolism in young patients, but it seems to be as useful for older ones, in whom cerebral embolism risk is underestimated; atherogenic and cardioembolic causes may actually coexist, and both should be treated.
Fukujima
Marcia Maiumi
MM
Division of Neurological Emergencies, São Paulo Federal University, São Paulo, Brazil. maiumi@neuro.epm.br
Tatani
Solange Bernardes
SB
Aguiar
Alexandre Santos
AS
Ferraz
Maria Elisabeth Matta de Rezende
ME
Francisco
Silvio
S
Ferreira
Luiz Darcy
LD
Monaco
Cláudia G
CG
Ortiz
Juarez
J
Lima
João Augusto Costa
JA
Gabbai
Alberto Alain
AA
do Prado
Gilmar Fernandes
GF
D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D020766:Intracranial Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000209:etiology*