Abstract
Background and Purpose: Transesophageal echocardiography (TEE) is the gold standard for detecting the potential source of cardiac and aortogenic embolisms. To study the applicability of TEE, we reviewed TEE findings and compared pre- and post-TEE stroke diagnoses.
Method: We enrolled 120 acute or subacute ischemic stroke patients (82 male, 38 female; mean age, 66 years) who underwent TEE due to possible embolic mechanisms or undetermined stroke etiology.
Results: A right-to-left shunt was identified in 68 patients: patent foramen ovale (PFO) in 65 patients, pulmonary arteriovenous fistula in 2, and atrial septal fistula in one. Atrial septal aneurysms were identified in 4 patients, all of which were accompanied by PFO. A left atrial thrombus was detected in 3 patients, and a thrombus in the left atrial appendage in 11. A mobile thrombus was seen in 3 patients who had thrombi in the left atrial appendages. We found aortic plaques with ulcers in 6 patients, mobile aortic plaques in 6, and both in 3. A comparison of pre- and post-TEE stroke subtype diagnoses showed a decrease in the strokes of undetermined etiology from 36.7 to 19.2%.
Conclusion: TEE in acute or subacute stroke patients is useful not only for more precise detection of the embolic source but also for understanding the detailed stroke mechanism, allowing for more adequate treatments.
