Transesophageal Echocardiographic Findings of Ischemic Stroke without Obvious Cardiac Disease

ABSTRACT

To detect the cardiac source of embolism in patient of ischemic stroke of uncertain etiology, biplane transesophageal echocardiography and contrast echocardiography with hand-agitated saline were performed 27 patients(sixteen men and eleven women) of transient ischemic attack and cerebral infarction without definitive cardiac symptom and sign. Transesophageal echocardiography showed potential sources of embolism in nineteen patients (70.4%) including atrial septal aneurysm(n = 9, three of them had patent foramen ovale), spontaneous contrast echo(n = 3), mitral valve prolapse(n= 1), unknown thickening of the tip of the mitral valve(n = 1) and atherosclerotic plaque in descending aorta(n = 7). Thus transesophageal echocardiography and contrast echocardiography identify potential cardiac source of embolism, and provide the rationale of the thrombolytic and anticoagulant therapy in patients with ischemic stroke without obvious cardiac disease.