title: Diagnostic yield of echocardiography in stroke: should we improve patient selection?
abstract: BACKGROUND
  Last year the European Society of Echocardiography published recommendations for the use of echocardiography in identifying potential sources of embolism as a cause of ischemic stroke in the absence of other cerebrovascular diseases. Both transthoracic echocardiography and transesophageal echocardiography play a fundamental role in the assessment, diagnosis and management of the embolic source. Due in part to the increased longevity of the population and improved survival of cardiac patients, we are now seeing a gradual increase in the application of echocardiographic studies as a diagnostic test. This has led us to critically analyse their performance in detecting various pathologies.
  
  
  OBJECTIVE
  Our aim was to analyse the diagnostic yield of transthoracic echocardiography in patients with cerebrovascular accident in a tertiary hospital.
  
  
  METHODS
  To this end, we retrospectively analysed all echocardiographic studies during 2010 requested from the Neurology Department with a diagnosis of stroke. We have studied the diagnostic yield of the test and its contribution to the etiological diagnosis based on major and minor echocardiographic criteria as recommended by the European Society of Echocardiography.
  
  
  RESULTS
  We found major echocardiographic criteria in 6 patients (5%) with embolic stroke and in 2 (0.7%) non embolic, P=.005. In view of our results, the performance of transthoracic echocardiography in patients with embolic stroke has a low diagnostic yield, which leads us to question systematic use of this technique.
authors.affiliation: Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, España.
authors.forename: S
authors.initials: S
authors.lastname: Secades
authors.forename: M
authors.initials: M
authors.lastname: Martín
authors.forename: C
authors.initials: C
authors.lastname: Corros
authors.forename: M L
authors.initials: ML
authors.lastname: Rodríguez
authors.forename: A
authors.initials: A
authors.lastname: García-Campos
authors.forename: J M
authors.initials: JM
authors.lastname: de la Hera Galarza
authors.forename: J L
authors.initials: JL
authors.lastname: Lambert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000209:etiology; D004452:Echocardiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology