Transesophageal Echocardiography Informative in Cryptogenic Stroke

NEW YORK, April 22, 2009 — Transesophageal echocardiography (TEE) can shed light on contributing cardiogenic factors in patients with cryptogenic cerebral ischemia, according to German and US researchers.

In a March 28 online publication in Cardiovascular Ultrasound, Dr Fabian Knebel of Charite Medical University Berlin, et al noted that in approximately 33% of patients with cerebral ischemia, no definite cause can be identified.

To evaluate the prevalence of abnormal echocardiographic findings in these patients, the researchers studied TEE results on 702 patients with ischemic stroke or a transient ischemic attack (TIA). Subjects also underwent a variety of other clinical and laboratory tests.

In more than half of patients (52.6%), TEE provided relevant findings. The most common overall were patent foramen ovale (21.7%) and previously undiagnosed valvular disease (15.8%). Other findings included aortic valve sclerosis and atrial septal defects.

Patients older than 55 years and patients with ischemic stroke had more relevant echocardiographic findings than younger patients or those with TIA.

Patent foramen ovale was more common in younger patients, however (26.8% vs 18%). This was also true of atrial septal defects (9.6% vs 4.9%).

Dr Knebel told Reuters Health that given these findings, "it appears that TEE examinations are indicated in all patients with cryptogenic stroke, regardless of their age."

Source: Reuters Health Information