Evaluation of cardiac sources of embolism

ABSTRACT

Cerebrovascular disease is a leading cause of mortality and morbidity .20% of cerebral infarcts are due to cerebral embolism of cardiac origin. Conditions associated with cardiogenic emboli are either rhythm abnormalities such as atrial fibrillation (AF) responsible for 50% , or structural abnormalities .Whereas left ventricle thrombus ,left atrium thrombus ,vegetation , tumor and protruding atherosclerotic plaque are considered as direct sources of embolization , others such as valvular disease , wall motion abnormality , atrial septal defect (ASD) , patent foramen ovale(PFO) , atrial septal aneurysm (ASA) and spontaneous echocardiographic contrast (SEC) are considered as indirect cardiac sources of embolization . In this article evaluation of cardiacsources of embolism and the role of echocardiography are discussed. Though both transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) play an important role,TEE appears to be more sensitive in identifying potential abnormalities in patients with suspected cardiac sources of emboli