[Utility of transesophageal echocardiography in young patients with cryptogenic stroke and low cardiovascular risk].
OBJECTIVE
Stroke is a high morbimortality disease. In young patients, as many as 40% of acute strokes have no clearly identifiable cause (cryptogenic stroke) and this group of patients had until now limited therapeutic possibilities. However, transesophagical echocardiography (TEE) is changing patient management.


METHODS
We studied 100 consecutive patients aged 55 years old or less with cryptogenic stroke. TEE was performed in all of them.


RESULTS
TEE was normal in 49 patients while in 51 patients it showed any abnormality: patent foramen ovale (PFO) was found in 29 patients, isolated atrial septal aneurysm (ASA) in 1 patient, PFO and ASA in 12 patients, 5 patients had a cardiac mass and in 4 patients we found severe aortic atherosclerotic plaques. Therefore, TEE showed a cardiac source of stroke in 51% of patients. We changed patient management in 46 patients (90.2% of patients with abnormal TEE), indicating percutaneous treatment in 38 patients, surgery in 3 patients and anticoagulant therapy in 5 patients.


CONCLUSIONS
TEE found a cardiac cause of stroke in 51% of young patients with cryptogenic stroke. These findings led to change the therapeutic management in 47% of patients. TEE seems to be a useful technique in young patients with cryptogenic stroke.
Rus Mansilla
Carmen
C
Unidad de Cardiología, Hospital Alto Guadalquivir, Andújar, Jaén, España. crusmansilla@yahoo.es
Mesa Rubio
Dolores
D
Suárez de Lezo Cruz Conde
José
J
Rodríguez Almodovar
Ana
A
Durán Torralbo
Carmen
C
Delgado Ortega
Mónica
M
D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology; D003663:Decision Trees; D017548:Echocardiography, Transesophageal; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy