Authors: Nguyen Tuan Vu, Le Huu Quynh Trang.
Background: Cardiogenic embolism accounts for 15 to 40% of all ischemic stroke. In general, cardiogenic embolic stroke is a severe case and usually recurrent, treatment and prognosis are different from other strokes. Cardiac embolic strokes need to be diagnosed by imaging tools with evidence of cardiac resources of embolism. Transthoracic Echocardiography and Transesophageal Echocardiography are useful tools for detection of the cardioembolic resources.
Cardioembolic strokes may have symptoms and signs (atrial fibrillation, rheumatic heart disease, infective endocarditis ...) but may not have any symptom and sign even have normal result on transthoracic ehocardiography in some cardioembolic strokes (Patent Foramen Ovale, IAS aneurysm...).
Purpose: By echocardiography (transthoracic and transesophageal) detection of cardiacembolic resources in suspected cardioembolic stroke patients.
Methods: Suspected cardiogenic embolic strokes were refered to our department to perfome echocardiography. All patients were determined cerebral infarction or TIA by neurologist with appropriate results of brain MRI or MSCT. Transthoracic Echocardiography was formerly performed, and Transesophageal Echocardiography followed latter in patients who had negative or unexplained findings on Transthoracic Echocardiography.
Results: 63patients (59 strokes and 4 transient ischemic attacks) including 28 men and 35 women, mean age 49 ± 15. Transthoracic Echocardiography was done for all patients, Only 14 cases of Transesophageal Echocardiography were performed (2 cases of left atrial dilation due to intermittent atrial fibrillation, 12 cases of normal result on Transthoracic Echocardiography). In 2 cases with left atrial dilation we found spontaneous contrast in the LA and
LAA. In 12 cases of normal result on Transthoracic Echocardiography , there were 9 cases of PFO, 1 case of PFO associated with IAS aneurysm and 2 normal results.
Conclusion: Beside major risk cardiogenic sources, echocardiography can detect underlying cardiac lesions of cardioembolic stroke. TTE has been shown to be effective in detecting potential cardiac sources at ventricles. TTE associated with TEE obtain more effectiveness in detection of cardiogenic sources.
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