Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients.
BACKGROUND
The role of transesophageal echocardiography (TEE) in the evaluation of acute stroke patients is still ill-defined. We conducted a prospective observational study to find the prevalence of TEE findings that indicate anticoagulation as beneficial, in acute ischemic stroke patients without indication for anticoagulation based on clinical, electrocardiographic and transthoracic echocardiography (TTE) findings.


METHODS
We prospectively studied all patients referred to our laboratory for TTE and TEE. Patients were excluded if the diagnosis was not acute ischemic stroke or if they had an indication for anticoagulation based on clinical, electrocardiographic, or TTE data. Patients with TEE findings that might indicate anticoagulation as beneficial were identified.


RESULTS
A total of 84 patients with acute ischemic stroke and without indication for anticoagulation based on clinical and electrocardiographic or TTE data were included in the study. Findings indicating anticoagulation as beneficial were found in 32.1%: spontaneous echo contrast (1.2%), complex aortic atheroma (27.4%), thrombus (8.3%), and simultaneous patent foramen ovale and atrial septal aneurysm (2.4%).


CONCLUSIONS
The results of our study show that TEE can have therapy implications in 32.1% of ischemic stroke patients in sinus rhythm and with TTE with no indication for anticoagulation.
de Abreu
Tiago Tribolet
TT
Laboratorio de Ultrasonografia Cardiaca e Neurovascular, Hospital do Espirito Santo-Evora E. P. E., Portugal. ttabreu@clix.pt
Mateus
Sonia
S
Carreteiro
Cecilia
C
Correia
Jose
J
D000925:Anticoagulants / Q000627:therapeutic use*; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology*; D013927:Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging*
D000925:Anticoagulants