title: Stroke echoscan protocol: a fast and accurate pathway to diagnose embolic strokes.
abstract: OBJECTIVE
  Cardiac Echoscan is the simplified transthoracic echocardiogram focused on the main source of emboli detection in the acute stroke diagnosis (Stroke Echoscan). We describe the clinical impact related to the Stroke Echoscan protocol in our Center.
  
  
  METHODS
  Acute stroke patients who underwent the Stroke Echoscan by a trained stroke neurologist were included (Echoscan group). All examinations were reviewed by cardiologists. The main embolic stroke etiologies were: ventricular akinesia (VA), severe aortic atheroma (AA) plaque and cardiac shunt (SHUNT). The rate of the embolic stroke etiologies and the median length of stay (LOS) were compared with a cohort of patients studied by cardiologist (Echo group).
  
  
  RESULTS
  Eighty acute stroke patients were included. The sensitivity (S) and specificity (E) were: VA (S 98.6%, E 66.7%, k = .7), AA (S 93.3%, E 96.9%, k = .88) and SHUNT (S 100%, E 100%, k = 1), respectively. The rate of AA diagnosis was significantly higher in Echoscan group (18.8% vs. 8.9%; P = .05). Echoscan protocol significantly reduced the LOS: 6 days (IQR 3-10) versus Echo group 9 days (IQR 6-13; P < .001).
  
  
  CONCLUSIONS
  The Echoscan protocol was an accurate quick test, which reduced the length of stay and increased the percentage of severe AA plaque diagnosis.
authors.affiliation: Stroke Unit and Cerebral Hemodynamics, Department of Neurology, Vall d´Hebrón General Hospital, Barcelona, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Pagola
authors.forename: Teresa
authors.initials: T
authors.lastname: González-Alujas
authors.forename: Marian
authors.initials: M
authors.lastname: Muchada
authors.forename: Gisela
authors.initials: G
authors.lastname: Teixidó
authors.forename: Alan
authors.initials: A
authors.lastname: Flores
authors.forename: Sophie
authors.initials: S
authors.lastname: De Blauwe
authors.forename: Laia
authors.initials: L
authors.lastname: Seró
authors.forename: David Rodríguez
authors.initials: DR
authors.lastname: Luna
authors.forename: Marta
authors.initials: M
authors.lastname: Rubiera
authors.forename: Marc
authors.initials: M
authors.lastname: Ribó
authors.forename: Sandra
authors.initials: S
authors.lastname: Boned
authors.forename: José
authors.initials: J
authors.lastname: Álvarez-Sabin
authors.forename: Arturo
authors.initials: A
authors.lastname: Evangelista
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Molina
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D019091:Critical Pathways / Q000592:standards*; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000592:standards*; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000592:standards; D020766:Intracranial Embolism / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013030:Spain; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology
keywords: Embolic stroke; aortic atheroma plaque; echocardiography; length of admission