Cor Vasa 2014, 56(6):e456-e462 | DOI: 10.1016/j.crvasa.2014.07.001

The findings of the oesophageal echocardiography in patients with acute cerebral ischaemia

Markéta Pešková^*, Jan Lhotský, Richard Rokyta

Kardiologické oddělení, Fakultní nemocnice Plzeň, Komplexní kardiovaskulární centrum, Lékařská fakulta v Plzni, Univerzita Karlova v Praze, Plzeň, Česká republika

Introduction: The cerebrovascular accident ranks among the main causes of mortality and morbidity worldwide. In the Czech Republic, the cerebrovascular disease was the direct cause of the death in 10% of the cases of death in the year 2012 (Healthcare Annual CZ 2012).

Aim: The aim of our study was to evaluate the transoesophageal echocardiogram findings (TOE) in patients with suspicion for cardioembolic stroke or TIA who were indicated to this examination in our echocardiography laboratory.

Methodology: During the period from July 2009 to March 2013 (45 months), 108 TOE had been realized in our echocardiographic laboratory that was indicated for ischemic stroke or TIA. We monitored the occurrence of pathological findings that have the cardioembolic potential according to the literature.

Results: The examination was performed for a suspect of an infective endocarditis 10 times, this was proven in 3 cases. 5 patients were holders of a mechanical valvular prosthesis, its dysfunction was discovered in neither case. The most frequent diagnosis was foramen ovale patens in the other patients (30 patients, i.e. 37%), in 3 cases it occurred simultaneously with an atrial septal aneurysm. We found a haemodynamic little significant atrial septal defect in 3 patients, a presence of an endocardial thrombus in 2 patients. A left atrial dilation and a systolic dysfunction of a left atrium auricle can relate with an occurrence of an atrial fibrillation. A left atrium volume was determined in 86 cases, only 35 patients (i.e. 40.7%) have the normal left atrium volume. A pathology, which can be connected with a cerebral ischemia that took place, was found in 56% of the patients.

Conclusion: Transoesophageal echocardiography is an independent method in examination of potential sources of cardioembolism. In our sample, a pathology in more than half of the patients was diagnosed that could refer to a suffered ischemic stroke and the diagnosis led to a change in a treatment strategy in 17 cases of the total number of 95 patients (i.e. at 18%).

Keywords: Cardioembolism; Ischaemic stroke; Transoesophageal echocardiography

Received: March 14, 2014; Revised: July 3, 2014; Accepted: July 9, 2014; Published: December 1, 2014  Show citation