title: Prevalence of pulmonary embolism in patients with suspected cardioembolic ischemic stroke.
abstract: OBJECTIVE
  Venous thromboemboli can cause both pulmonary embolism (PE) and paradoxical embolism in the presence of a cardiac right-to-left shunt. Our aim was to prospectively assess the prevalence of PE in patients with ischemic stroke with suspected cardiogenic etiology and thereby to clarify the possible role of paradoxical embolism as a cause of ischemic stroke.
  
  
  METHODS
  Consecutive patients with suspected cardiogenic ischemic stroke (n=113, male/female=76/37, mean age 62±11 y) underwent computed tomography angiography of the pulmonary arteries to assess for the presence of PE as an adjunct to routine computed tomography angiography of the cervicocranial arteries. Transthoracic and transesophageal echocardiography were used to evaluate for patent foramen ovale (PFO) and cardiac defects.
  
  
  RESULTS
  PE was found in 4 patients (3.5%). Only 1 patient with PE had symptoms or signs suggestive of PE. None of the patients with PE had intracardiac defects or PFO. In the entire study population, atrial septal defect was detected in 5 (4%) patients and PFO in 13 (12%) patients.
  
  
  CONCLUSIONS
  The prevalence of PE in patients with ischemic stroke with suspected cardiogenic etiology is low. This study does not support a significant association between PE and cardiogenic ischemic stroke.
authors.affiliation: Department of Clinical Radiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland. petri.sipola@kuh.fi
authors.forename: Petri
authors.initials: P
authors.lastname: Sipola
authors.forename: Marja
authors.initials: M
authors.lastname: Hedman
authors.forename: Pekka
authors.initials: P
authors.lastname: Jäkälä
authors.forename: Anne-Mari
authors.initials: AM
authors.lastname: Karjalainen
authors.forename: Keijo
authors.initials: K
authors.lastname: Peuhkurinen
authors.forename: Hannu
authors.initials: H
authors.lastname: Manninen
authors.forename: Ritva
authors.initials: R
authors.lastname: Vanninen
mesh_terms: D000369:Aged, 80 and over; D002545:Brain Ischemia; D017023:Coronary Angiography; D004452:Echocardiography; D019320:Embolism, Paradoxical / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging